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New York 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–$10%50%10th$1Professionalmedian $1 · 10th–90th $1–$20%20%40%10th90th$1$1.0$10.0$100.0$1.0K$10.0K

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
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.07 / $1.74 / $1.82
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.17 / $1.17 / $1.29
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.17 / $1.17 / $1.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $0.87 / $8.32
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.45 / $1.45 / $1.86
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.85 / $0.85 / $1.12
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.12 / $1.12
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.82 / $50,118.72 / $75,857.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.45 / $1.45 / $64.57
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.85 / $1.12 / $1.12
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.12 / $1.12