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Enteral Formula, Modular, Nutritionally Incomplete

Arkansas rates for HCPCS B4155

Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit

Rates data updated July 2026.

Facilitymedian $398,107 · 10th–90th $1$933,2540%20%10th90th$398,107Professionalmedian $1 · 10th–90th $1$10%50%10th90th$1$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.71
Median
$0.71
Typical High
$0.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.68
Median
$0.71
Typical High
$0.79
BCBS
Setting
Facility
Modifier
Global
Typical Low
$218,776.16
Median
$524,807.46
Typical High
$954,992.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$1.45
Typical High
$1.91
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.63
Median
$5.89
Typical High
$5.89
United
Setting
Professional
Modifier
Global
Typical Low
$0.31
Median
$0.93
Typical High
$1.41