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Missouri 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–$30%20%40%10th90th$3Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$0.0$0.1$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
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
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $1.86 / $2.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.12 / $3.24 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $2.69 / $2.75
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $2.04 / $2.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $2.69 / $2.69