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Idaho 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

Facilitymedian $3 · 10th–90th $2$50%20%10th90th$3Professionalmedian $1 · 10th–90th $1$20%50%90th$1$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
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.40 / $2.75 / $5.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.51 / $2.51 / $2.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.12 / $1.12 / $3.80
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $3.02 / $4.27