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Kentucky 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 $85 · 10th–90th $85–$53,7030%50%90th$85Professionalmedian $1 · 10th–90th $1–$10%20%40%10th90th$1$0.5$5.0$50.0$500.0$5.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $1.26 / $1.26
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41,686.94 / $44,668.36 / $56,234.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $8.32 / $8.32