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Enteral Formula, Nutionally Complete, Hyrdrolyzed Proteins

B4153 is the Healthcare Common Procedure Code System (HCPCS) code used to bill for this item. Estimates below are based on Medica Choice network contract rates.

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Enteral Formula, Nutionally Complete, Hyrdrolyzed Proteins

Facility Name	Average Cost Range How were these costs calculated?
Altru Medical Products	$2.00 - $2.60
Apria Healthcare	$2.00 - $2.60
Handi Medical Supply	$2.00 - $2.60
Key Medical Supply Inc	$2.00 - $2.60
MeritCare HealthCare Accessories, Medical Equipment	$2.00 - $2.60
Midwest Medical Equipment & Supply	$2.00 - $2.60
Fairview Home Infusion	$2.90 - $3.10
Allina Home Oxygen & Medical Equipment	$3.40 - $3.65
Pediatric Home Service	$3.40 - $3.65

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