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Michigan 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 $2 · 10th–90th $1–$40%5%10%10th90th$2Professionalmedian $1 · 10th–90th $1–$10%20%10th90th$1$0.2$0.5$1.0$2.0$5.0

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
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.02 / $1.17
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $2.40 / $4.57
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $0.93 / $0.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.85 / $0.95 / $3.09
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.81 / $1.07 / $1.62
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $0.65 / $1.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.66 / $0.81 / $1.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $1.17 / $1.70