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Nebraska 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 $646 · 10th–90th $1–$1,2590%10%10th90th$646Professionalmedian $1 · 10th–90th $1–$30%50%90th$1$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $3.24 / $3.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $3.02
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $794.33 / $1,548.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.34 / $2.45 / $2.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $2.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.12 / $3.02 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.12 / $2.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.14 / $2.14 / $2.14