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Arizona 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 $4 · 10th–90th $1–$100%5%10%10th90th$4Professionalmedian $2 · 10th–90th $1–$30%20%40%10th90th$2$0.5$2.0$10.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $3.47 / $3.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.17 / $4.90 / $9.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.56 / $0.74 / $5.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.51 / $1.02 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.69 / $1.20 / $1.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $0.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $1.17 / $1.70