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Idaho 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$20%10%20%10th90th$1Professionalmedian $0 · 10th–90th $0$10%50%90th$0$0.5$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.81 / $1.00 / $1.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.95 / $0.95 / $0.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.49
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.15 / $1.62