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Florida rates for HCPCS B4161

Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.11 / $2.74 / $2.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $2.74 / $2.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.74
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.85 / $2.85 / $2.85
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $1.87 / $2.29