go back

Oregon 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
$0.33 / $0.34 / $0.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.42 / $0.42
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.49 / $1.18
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $0.80 / $79,999.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $1.07 / $2.58
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $1.09 / $1.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00