go back

Maryland 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
Professional
Modifier
Low / Median / High Price
$0.53 / $0.92 / $1.27
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.20 / $1.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $1.80 / $1.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.65 / $0.85 / $1.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.89 / $1.88
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.06 / $1.06