go back

Kansas 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $1.07 / $1.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $0.78 / $0.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.77 / $0.77 / $0.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.42 / $0.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.98 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33