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Alaska 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–$110%20%10th90th$1Professionalmedian $3 · 10th–90th $1–$30%20%40%10th90th$3$1.0$2.0$5.0$10.0$20.0$50.0

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $3.16 / $3.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.72 / $1.20 / $10.72
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $1.26 / $4.07
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.26 / $1.26 / $1.26
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $1.20 / $1.20
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.72 / $1.02 / $10.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $60.26 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.70 / $1.82 / $3.09