go back

Kansas rates for HCPCS B4158

Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit

Facilitymedian $2 · 10th–90th $2–$20%50%10th90th$2Professionalmedian $2 · 10th–90th $1–$20%50%10th90th$2$0.5$2.0$10.0$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
Facility
Modifier
Typical Low / Median / Typical High
$1.78 / $1.78 / $1.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.78 / $2.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.70 / $1.78 / $1.91
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $1.78 / $1.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.52 / $0.52 / $0.52
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.41 / $1.41 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.40 / $0.40 / $0.40