go back

Enteral Formula, Modular, Nutritionally Incomplete

North Dakota 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 $1 · 10th–90th $1$10%50%90th$1Professionalmedian $1 · 10th–90th $1$10%20%10th90th$1$0.5$1.0$2.0

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
$0.69
Median
$0.69
Typical High
$0.91
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.69
Median
$0.69
Typical High
$0.91
BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.72
Median
$0.83
Typical High
$1.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$1.41
Medica
Setting
Facility
Modifier
Global
Typical Low
$0.69
Median
$1.17
Typical High
$2.04
Medica
Setting
Professional
Modifier
Global
Typical Low
$0.47
Median
$0.85
Typical High
$1.48
United
Setting
Professional
Modifier
Global
Typical Low
$0.47
Median
$0.95
Typical High
$1.41