BACK




          
          

               

                    
Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins

		

B4153 is the Healthcare Common Procedure Code System (HCPCS) code used to bill for this item.



Note: The estimates below are based on Medica Choice network contract rates. How were these costs calculated?




               

               


                    

                    

                    

                    

                         

                    

               

               

          

          
          
          

               

               

               

               

                    

                         

                              

                                   
Cost Key:

                                   Lower Cost
                                   Medium Cost
                                   Higher Cost

                              

                         

                    




                    

                                        
                         

                              

                                   
                                   		 Facility     
                                   City/State                                 
                                   
                                        Average Cost Range     
                                     
                                   
                                                                                                                                                                
                              

                         
                        
                         

                         

                         

                         
                               
                                   

                                         
                                        Sanford HealthCare Accessories
                                        Bemidji, MN
                                        $1.71 - $2.07
                                         
                   
                                   

                             
                                   

                                         
                                        Pediatric Home Services
                                        Roseville, MN
                                        $7.65 - $8.12
                                         
                   
                                   

                             
                                   

                                         
                                        Fairview Cedar Ridge Pharmacy
                                        Apple Valley, MN
                                        $1.71 - $2.07
                                         
                   
                                   

                             
                                   

                                         
                                        Fairview Home Infusion
                                        Minneapolis, MN
                                        $1.71 - $2.07
                                         
                   
                                   

                                                               
                              


                         

                    





                    

               


               

                    
Links to other websites are provided for your convenience and are for informational purposes only. The information given by these websites is not medical advice and is not intended as a substitute for medical care provided by a physician. Medica assumes no responsibility for any circumstances arising out of the use, misuse, interpretation or application of any information or other material provided on these sites.