go back

Nebraska 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 / $4.90 / $4.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.73 / $0.73 / $6.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$609.59 / $801.77 / $1,675.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.73 / $6.21 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $3.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.48
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.80 / $3.00 / $3.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.14 / $3.14 / $3.14