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Enteral Formula, Modular, Nutritionally Incomplete

South 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.

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

$1.12

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $1.12 for this service. Most negotiated rates run $0.98 to $1.41.

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.

How much rates vary

Facilitymedian $2 · 10th to 90th $1 to $2Professionalmedian $1 · 10th to 90th $1 to $1
$0.5$1$2facility $2professional $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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.69
Median
$1.78
Typical High
$1.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.91
Median
$1.07
Typical High
$1.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$1.41
Medica
Setting
Facility
Modifier
Global
Typical Low
$1.12
Median
$1.55
Typical High
$2.95
Medica
Setting
Professional
Modifier
Global
Typical Low
$0.32
Median
$0.95
Typical High
$1.66
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1.23
Median
$1.23
Typical High
$1.23
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$0.87
Median
$1.02
Typical High
$2.14
United
Setting
Professional
Modifier
Global
Typical Low
$0.32
Median
$0.95
Typical High
$1.58
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$1.12

Where South Dakota 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.

South Dakota· 6th of 51

$1.12

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.