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    
  Apria Healthcare LLC Rochester, MN $7.67 - $12.46
  Fairview Home Infusion Minneapolis, MN $2.02 - $2.08
  Fairview Northeast Pharmacy Minneapolis, MN $2.02 - $2.08
  Lincare Inc Alliance, NE $2.02 - $2.08
  Pediatric Home Services Roseville, MN $7.67 - $12.46