HCPCS B4103
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit
Current code18 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $5.14 – $5.94 | — | — |
| Deaconess Medical Center | $4.01 – $5.14 | — | — |
| Mary Bridge Children's Hospital | $5.14 – $7.06 | — | — |
| MultiCare Auburn Medical Center | $5.14 – $7.06 | — | — |
| MultiCare Covington Medical Center | $5.14 – $7.06 | — | — |
| MultiCare Good Samaritan Hospital | $5.14 – $7.06 | — | — |
| MultiCare Valley Hospital | $4.01 – $5.14 | — | — |
| Overlake Hospital Medical Center & Clinics | $6.01 – $6.68 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $2.86 | — | — |
| Providence Holy Family Hospital | $2.86 | — | — |
| Providence Regional Medical Center Everett | $2.86 | — | — |
| Swedish Edmonds Hospital | $2.86 | — | — |
| Swedish Issaquah | $2.86 | — | — |
| Swedish Medical Center | $2.86 | — | — |
| Swedish Medical Center / Cherry Hill | $2.86 | — | — |
| Tacoma General Allenmore Hospital | $5.14 – $7.06 | — | — |
| Virginia Mason Medical Center | $8.54 | — | — |
| Yakima Valley Memorial | $4.98 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.