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Maine 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–$10%50%10th90th$1Professionalmedian $1 · 10th–90th $1–$20%50%10th90th$1$0.5$1.0$2.0$5.0$10.0$20.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.16 / $3.16 / $3.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.78 / $0.93 / $1.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.71 / $0.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.41 / $1.38 / $1.74
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.16 / $3.16 / $3.16
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.41 / $1.38 / $1.74