go back

Kansas rates for HCPCS B4159

Enternal Formula For Pediatrics Nutritionally Complete Soy Based With Intact

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $1.85 / $1.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.81 / $0.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.82 / $0.82 / $0.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.88 / $0.88 / $0.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $1.79 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $0.40 / $0.40