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Kentucky 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.62 / $0.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.62 / $0.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $1.25 / $1.25
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.60 / $1.08
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.60 / $1.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $4.09 / $18.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $1.15 / $12.65