go back

Idaho rates for HCPCS B4159

Enteral formula, for pediatrics, nutritionally complete soy based 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 $1 · 10th–90th $1–$30%20%10th90th$1Professionalmedian $1 · 10th–90th $1–$10%50%10th$1$0.5$1.0$2.0

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
$1.00 / $1.00 / $1.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.26 / $1.45 / $2.75
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.48 / $1.48 / $1.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $0.87 / $0.87
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.41 / $0.41 / $0.59
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.62 / $2.29