go back

Ohio 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%10th90th$1Professionalmedian $1 · 10th–90th $1–$20%20%10th90th$1$0.5$1.0$2.0$5.0$10.0

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
$7.94 / $7.94 / $8.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.02
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.23 / $1.23 / $1.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.79 / $0.83 / $1.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $0.93 / $1.51
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.59 / $0.59 / $0.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.78 / $1.82 / $1.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.15 / $1.74 / $2.63
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $1.51
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.17 / $1.38 / $2.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.66 / $0.66 / $1.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $1.12 / $1.78