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Enteral Formula, Inherited Disease of Metabolism

Tennessee rates for HCPCS B4157

Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Rates data updated October 2026.

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $1Professionalmedian $1 · 10th to 90th $1 to $8
$1$2$5facility $1professional $1

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$0.72
Median
$0.72
Typical High
$0.72
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.72
Median
$0.72
Typical High
$0.72
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.11
Median
$0.11
Typical High
$0.11
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.07
Median
$0.07
Typical High
$0.07
Cigna
Setting
Professional
Modifier
None
Typical Low
$8.13
Median
$8.13
Typical High
$8.13