go back

Massachusetts 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
$0.60 / $0.60 / $0.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.51 / $0.60 / $0.65
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.77 / $0.94 / $90.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.77 / $1.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.01 / $1.24 / $2.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $1.80 / $1.80
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $3,504.00 / $9,239.00
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.62 / $1.62 / $90.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $1.15 / $2.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $1.19 / $1.99