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Nationwide rates for HCPCS B4154

Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Facilitymedian $1 · 10th–90th $1$30%20%40%10th90th$1Professionalmedian $1 · 10th–90th $1$30%20%40%10th90th$1$0.0$0.5$10.0$200.0$5.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.02 / $1.02 / $1.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.02 / $3.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.51 / $0.69 / $1.62
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.68 / $0.79 / $1.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $2.40 / $6.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.51 / $1.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.66 / $0.79 / $1.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.45 / $1.17 / $2.00