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California 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–$20%10%20%10th90th$1Professionalmedian $2 · 10th–90th $1–$30%20%10th90th$2$0.5$2.0$10.0$50.0$200.0

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
Facility
Modifier
Typical Low / Median / Typical High
$3.47 / $3.47 / $3.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $3.47 / $3.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.51 / $0.65 / $1.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.72 / $0.89 / $16.22
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.15 / $1.82 / $3.16
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $1.32 / $3.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $0.83 / $0.91
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.26 / $2.88
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.91 / $1.12 / $3.89
Molina
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 / $0.83 / $10.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $1.82 / $1.82
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.86 / $1.86 / $1.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $1.32 / $2.88