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California rates for HCPCS B4160

Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Facilitymedian $1 · 10th–90th $1–$10%20%10th90th$1Professionalmedian $3 · 10th–90th $0–$400%20%40%10th90th$3$0.5$2.0$10.0$50.0$200.0

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
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.07 / $1.07 / $3.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.87 / $0.98 / $1.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $1.12 / $1.17
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $3.98
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.40 / $2.40 / $2.40
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.34 / $0.47 / $1.07
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.42 / $0.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.39 / $3.39 / $3.39