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New Jersey 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%100%$1Professionalmedian $1 · 10th–90th $1–$10%50%90th$1$0.5$1.0$2.0

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
$1.02 / $1.02 / $1.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.82 / $1.82
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $0.65 / $0.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.79 / $0.79 / $0.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.83 / $2.00