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Iowa 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%50%$1Professionalmedian $1 · 10th–90th $1–$10%50%10th$1$0.5$2.0$10.0$50.0

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
Facility
Modifier
Typical Low / Median / Typical High
$1.07 / $1.07 / $1.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.07 / $1.07 / $1.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.93 / $0.95
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $1.78 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.95 / $100.00 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.83 / $1.20
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.95 / $0.95 / $1.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.49 / $0.49 / $0.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.49 / $0.49 / $0.49
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00