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Enteral Formula, Modular, Nutritionally Incomplete

Arizona 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 October 2026.

How much does Enteral Formula, Modular, Nutritionally Incomplete cost?

$0.98

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $0.98 for this service. Most negotiated rates run $0.76 to $3.55.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3 · 10th to 90th $1 to $6Professionalmedian $1 · 10th to 90th $1 to $2
$0.5$2$10$50facility $3professional $1

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.52
Median
$0.52
Typical High
$0.55
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.05
Median
$0.05
Typical High
$0.06
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$0.91
Median
$3.72
Typical High
$6.31
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$0.63
Median
$0.83
Typical High
$1.45
Cigna
Setting
Professional
Modifier
None
Typical Low
$5.89
Median
$5.89
Typical High
$5.89
Medica
Setting
Facility
Modifier
None
Typical Low
$0.52
Median
$0.74
Typical High
$89.13
Medica
Setting
Professional
Modifier
None
Typical Low
$0.68
Median
$0.98
Typical High
$1.45
United
Setting
Professional
Modifier
None
Typical Low
$0.68
Median
$0.95
Typical High
$1.74
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.08
Median
$0.08
Typical High
$0.08

Where Arizona sits

The same service costs 3.6 times more in Florida than in Alabama. 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.

Arizona· 21st of 51

$0.98

FL $1.70AL $0.47

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.