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Washington, DC rates for HCPCS B4154

Enteral Formulae Nutritionally Complete For Special Metabolic Needs Excludes Nteral Feeding Tube 100 Calories = 1 Unit (Special Coverage Instructions Apply. See Cim: 65-10 And

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.92 / $0.92 / $0.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.92 / $0.92 / $0.92
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.20 / $1.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.77 / $0.77 / $1.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.87 / $2.54