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Hawaii 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

Professionalmedian $1 · 10th–90th $1–$10%50%$1$2.0

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
$3.16 / $3.16 / $3.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.26 / $1.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.70 / $1.70