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Pediatric Enteral Formula, Soy-Based, Intact Nutrients

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

$1.20

Typical negotiated rate. In Kentucky, October 2026.

Insurers have agreed to pay about $1.20 for this service. Most negotiated rates run $0.71 to $1.26.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2 · 10th to 90th $1 to $85Professionalmedian $1 · 10th to 90th $1 to $1
$1$2$5$10$20$50facility $2professional $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
$0.83
Median
$1.86
Typical High
$1.86
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.83
Median
$1.86
Typical High
$1.86
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$0.71
Median
$1.07
Typical High
$1.26
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$0.52
Median
$0.79
Typical High
$1.20
Cigna
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Cigna
Setting
Professional
Modifier
None
Typical Low
$0.87
Median
$10.23
Typical High
$10.23
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$0.11
Median
$0.11
Typical High
$0.11

Where Kentucky sits

The same service costs 199.5 times more in Montana than in Utah. 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.

Kentucky· 20th of 51

$1.20

MT $79.43UT $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.