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Illinois 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 $1–$190%10%20%10th90th$3Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$5.0$20.0$100.0

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
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $3.39
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
$3.24 / $7.41 / $28.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.34 / $2.34 / $2.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $6.76 / $199.53
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20