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Virginia 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 $0–$10,0000%20%10th90th$1Professionalmedian $1 · 10th–90th $1–$20%50%10th90th$1$0.0$0.2$2.0$20.0$200.0$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
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 / $1.07 / $1.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.02 / $1.02 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $0.87 / $0.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.43 / $1.55 / $1.86
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $7,413.10 / $10,964.78
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $7,413.10 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.17 / $1.17 / $1.17