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Alabama 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.53 / $0.53 / $0.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.54 / $0.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.29 / $1.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $1.80 / $2.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.75 / $1.62