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Missouri 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–$30%20%40%10th90th$1Professionalmedian $1 · 10th–90th $0–$10%20%10th90th$1$0.0$0.1$0.5$2.0$10.0$50.0

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
$1.02 / $1.07 / $1.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.07 / $3.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.83 / $0.83 / $2.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.56 / $0.71 / $1.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $1.62 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.38 / $0.87 / $1.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $1.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.38 / $0.91 / $1.74