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Nationwide rates for HCPCS B4159

Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit

Facilitymedian $1 · 10th–90th $1$850%20%10th90th$1Professionalmedian $1 · 10th–90th $1$20%50%10th90th$1$0.0$0.5$10.0$200.0$5.0K$100.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.86 / $1.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.83 / $0.93 / $1.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.81 / $1.07 / $1.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.69 / $3.80 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $1.12 / $1.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.89 / $1.17 / $1.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.07 / $1.66 / $3.16