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Iowa 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%50%90th$1Professionalmedian $1 · 10th–90th $1–$30%50%10th90th$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
$1.02 / $1.02 / $1.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.02 / $3.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.35 / $1.41
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $1.12 / $2.75
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.71 / $1.62 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.50 / $1.45 / $2.24
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.58 / $1.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.85 / $0.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.91 / $2.24
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.23 / $1.23 / $1.23