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Enteral Formula, Nutritionally Complete, Calorically Dense

Pennsylvania rates for HCPCS B4152

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Rates data updated July 2026.

How much does Enteral Formula, Nutritionally Complete, Calorically Dense cost?

$0.32

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $0.32 for this service. The price depends on where it is billed: about $0.32 from a physician practice, and about $0.32 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$0.32$0.26 to $0.38
FacilityA hospital or hospital-owned outpatient department$0.32$0.26 to $2.57

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $4Professionalmedian $0 · 10th to 90th $0 to $1
$1$10$100$1K$10Kfacility $0professional $0

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.26
Median
$0.26
Typical High
$0.32
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.24
Median
$0.32
Typical High
$1.66
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$0.38
Median
$0.38
Typical High
$0.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.24
Median
$0.24
Typical High
$0.24
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$0.26
Median
$0.26
Typical High
$0.32
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$0.24
Median
$0.28
Typical High
$0.40
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$0.62
Median
$2.57
Typical High
$4.57
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$0.44
Median
$0.44
Typical High
$0.51
United
Setting
Professional
Modifier
Global
Typical Low
$0.22
Median
$0.48
Typical High
$0.78

Where Pennsylvania sits

The same service costs 2.6 times more in Hawaii than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 44th of 51

$0.32

HI $0.59WV $0.23

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.