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Wyoming 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

Professionalmedian $2 · 10th–90th $2–$20%50%10th$2$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
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $2.24 / $2.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $0.87 / $0.87