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North Carolina 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–$890%20%10th90th$1Professionalmedian $1 · 10th–90th $1–$30%20%10th90th$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $3.47
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.93 / $0.95 / $1.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.85 / $0.93 / $1.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $0.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.45 / $1.45 / $2.51
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13