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Indiana rates for HCPCS B4157

Enternal Formula Nutritionally Complete For Special Metabolic Needs For

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.73 / $0.73 / $0.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.73 / $0.73
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.49 / $2.49 / $4.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $2.49 / $3.35
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.84 / $7.84 / $7.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.29 / $3.29 / $3.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.14 / $4.17 / $4.41