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Michigan 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 $2 · 10th–90th $1–$40%5%10%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$0.5$1.0$2.0$5.0

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
$3.98 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.07 / $3.24 / $3.24
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.98 / $2.29 / $4.47
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.72 / $0.78 / $0.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.83 / $0.93 / $3.47
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $1.32 / $1.82
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42