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Georgia 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 $2 · 10th–90th $1–$30%20%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%20%10th90th$1$0.0$0.1$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
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $1.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.02
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.83 / $2.51 / $3.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.51 / $0.72 / $2.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.85 / $1.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.85 / $0.85 / $1.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $1.32 / $2.04