go back

Virginia 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 $1 · 10th–90th $0–$10,9650%20%10th90th$1Professionalmedian $1 · 10th–90th $1–$20%50%10th90th$1$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$1.07 / $1.07 / $1.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.12 / $1.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.49 / $0.49 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $3.02
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.36 / $0.91 / $1.07
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.45 / $4,073.80 / $10,964.78
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.45 / $4,073.80 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $0.65 / $0.65