go back

New York 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 $2 · 10th–90th $1$30%20%40%10th90th$2Professionalmedian $3 · 10th–90th $1$30%20%40%10th90th$3$1.0$10.0$100.0$1.0K$10.0K

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 / $1.00
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
$2.51 / $2.63 / $3.63
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $2.45
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $2.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $14.45
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.82 / $2.88 / $3.55
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.09 / $2.09 / $2.51
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.09 / $2.24 / $2.24
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.57 / $50,118.72 / $75,857.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.88 / $2.88 / $64.57
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.09 / $2.95 / $2.95
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.09 / $2.24 / $2.95