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Oregon rates for HCPCS B4157

Enternal Formula Nutritionally Complete For Special Metabolic Needs For

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.73 / $6.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.16 / $8.16 / $8.16
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.73 / $1.04 / $5.39
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $79,999.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.04 / $8.23 / $20.04
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.16 / $8.46 / $8.61
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00