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Pediatric Enteral Formula, Soy-Based, Intact Nutrients

Alabama 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

Rates data updated October 2026.

How much rates vary

Professionalmedian $2 · 10th to 90th $1 to $2
$0.5$1$2professional $2

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.41
Median
$1.86
Typical High
$1.86
BCBS Alabama
Setting
Professional
Modifier
21 + 22 · Increased work + 31 + 41
Typical Low
$0.78
Median
$0.78
Typical High
$0.78
Cigna
Setting
Professional
Modifier
None
Typical Low
$0.87
Median
$0.87
Typical High
$1.07