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Texas 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 $100 · 10th–90th $0–$1000%50%10th$100Professionalmedian $1 · 10th–90th $0–$30%20%40%10th90th$1$0.5$2.0$10.0$50.0

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
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $3.24 / $3.24
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.34 / $0.49 / $1.07
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.33 / $3.24
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.78 / $1.12 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.34 / $0.49 / $1.07
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.42 / $0.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.72 / $0.72 / $1.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $0.83 / $1.02