go back

Florida rates for HCPCS B4155

Enteral Formula Nutritionally Incomplete/Modular Nutients Includes Specific Calories = 1 Unit (Special Coverage Instructions A

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.50 / $0.71 / $0.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $0.71 / $0.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.92 / $5.92 / $5.92
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.77 / $0.80 / $1.59
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.53 / $0.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.80 / $1.50
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $0.89 / $0.89