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Arkansas rates for HCPCS B4155

Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit

Facilitymedian $524,807 · 10th–90th $218,776–$954,9930%20%10th90th$524,807Professionalmedian $1 · 10th–90th $0–$60%20%40%10th90th$1$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $3.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.45 / $1.45 / $1.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.63 / $5.89 / $5.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.31 / $0.95 / $1.45