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Enteral Formula, Modular, Nutritionally Incomplete

Montana 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.

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

$1.38

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $1.38 for this service. The price depends on where it is billed: about $1.38 from a physician practice, and about $1.20 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 6 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$1.38$0.95 to $3.89
FacilityA hospital or hospital-owned outpatient department$1.20$1.17 to $1.74

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $2Professionalmedian $1 · 10th to 90th $1 to $4
$0.5$1$2$5$10$20$50facility $1professional $1

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
Professional
Modifier
Global
Typical Low
$0.85
Median
$0.85
Typical High
$3.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$1.07
Typical High
$1.07
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.17
Median
$1.17
Typical High
$1.17
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.17
Median
$1.17
Typical High
$1.17
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$0.95
Median
$1.70
Typical High
$1.74
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$0.95
Median
$1.70
Typical High
$1.74
Providence
Setting
Facility
Modifier
Global
Typical Low
$1.17
Median
$1.17
Typical High
$1.17
Providence
Setting
Professional
Modifier
Global
Typical Low
$1.17
Median
$79.43
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$1.02
Median
$1.29
Typical High
$1.51

Where Montana sits

The same service costs 3.6 times more in Wyoming than in Maine. 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.

Montana· 2nd of 51

$1.38

WY $1.78ME $0.49

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.