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Pediatric Enteral Formula, Soy-Based, Intact Nutrients

Georgia 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 July 2026.

How much does Pediatric Enteral Formula, Soy-Based, Intact Nutrients cost?

$0.41

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $0.41 for this service. Most negotiated rates run $0.41 to $1.07.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $0Professionalmedian $0 · 10th to 90th $0 to $1
$0.5$1.0$2.0$5.0facility $0professional $0

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.41
Median
$0.41
Typical High
$0.43
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.41
Median
$0.41
Typical High
$0.41
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$1.07
Typical High
$1.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.87
Median
$0.87
Typical High
$0.87
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.58
Typical High
$5.01

Where Georgia sits

The same service costs 5.6 times more in Wyoming than in Vermont. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Georgia $0.41 · 40th of 51
WY $2.24VT $0.40

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.