go back

Oregon 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 $1 · 10th–90th $1–$10%50%90th$1Professionalmedian $4 · 10th–90th $1–$60%20%10th90th$4$0.5$1.0$2.0$5.0$10.0$20.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $3.89 / $3.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $5.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.40 / $2.57
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.81 / $0.98 / $2.00
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $0.98 / $3.39
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.89 / $0.89 / $1.07
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.81 / $1.45 / $5.37
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $5.89 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.91 / $1.38 / $3.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.98 / $1.41 / $2.29