go back

Pediatric Enteral Formula, Soy-Based, Intact Nutrients

Massachusetts 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?

$0.46

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $0.46 for this service. The price depends on where it is billed: about $0.40 from a physician practice, and about $2.14 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 6 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$0.40$0.40 to $0.40
FacilityA hospital or hospital-owned outpatient department$2.14$2.14 to $2.82

How much rates vary

Facilitymedian $2 · 10th to 90th $0 to $5Professionalmedian $0 · 10th to 90th $0 to $2
$1$10$100$1Kfacility $2professional $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
$0.40
Median
$0.40
Typical High
$0.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.40
Median
$0.40
Typical High
$1.62
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$0.37
Median
$1.05
Typical High
$100.00
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$0.37
Median
$0.46
Typical High
$0.46
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2.14
Median
$2.14
Typical High
$4.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.87
Median
$0.87
Typical High
$1.23
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$8,511.38
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$0.37
Median
$1.05
Typical High
$100.00
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$0.37
Median
$0.46
Typical High
$0.46

Where Massachusetts 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.

Massachusetts· 22nd of 51

$0.46

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.