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Mississippi 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.88 / $0.88 / $0.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.88 / $0.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.74 / $0.74 / $0.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $1.80 / $1.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $1.20 / $1.76