go back

Pediatric Enteral Formula, Soy-Based, Intact Nutrients

Michigan 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?

$0.85

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $0.85 for this service. The price depends on where it is billed: about $0.41 from a physician practice, and about $1.66 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$0.41$0.41 to $0.89
FacilityA hospital or hospital-owned outpatient department$1.66$0.41 to $3.02

How much rates vary

Facilitymedian $2 · 10th to 90th $0 to $5Professionalmedian $0 · 10th to 90th $0 to $2
$0.5$1$2$5facility $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
$0.41
Median
$0.41
Typical High
$0.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.41
Median
$0.41
Typical High
$0.41
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.12
Median
$2.69
Typical High
$5.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.85
Median
$0.89
Typical High
$0.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.87
Median
$0.87
Typical High
$0.87
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$1.66
Median
$1.86
Typical High
$5.37
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$2.04
Typical High
$2.57

Where Michigan 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.

Michigan· 17th of 51

$0.85

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.