go back

Maryland 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
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.34
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.42 / $0.42
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $0.89 / $0.89