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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 July 2026.

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

$0.83

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $0.83 for this service. The price depends on where it is billed: about $0.83 from a physician practice, and about $0.41 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$0.83$0.41 to $1.26
FacilityA hospital or hospital-owned outpatient department$0.41$0.41 to $85.11

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $85Professionalmedian $1 · 10th to 90th $0 to $2
$1$10$100$1K$10Kfacility $0professional $1

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
$0.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.41
Median
$0.41
Typical High
$1.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.71
Median
$1.26
Typical High
$1.26
CareSource
Setting
Facility
Modifier
Global
Typical Low
$41,686.94
Median
$44,668.36
Typical High
$56,234.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.87
Median
$10.23
Typical High
$10.23

Where Kentucky sits

The same service costs 5.6 times more in Wyoming than in Vermont. 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· 19th of 51

$0.83

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.