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Texas 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 $1 · 10th–90th $1–$1000%20%40%10th90th$1Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$2.0$5.0$10.0$20.0$50.0$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 / $1.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.48 / $1.82 / $2.63
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.40 / $2.40 / $2.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.62 / $3.24
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $2.95 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.12 / $1.62 / $3.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.74 / $1.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $2.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.14 / $2.14 / $2.69