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Pediatric Enteral Formula, Soy-Based, Intact Nutrients

Minnesota 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?

$1.02

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $1.02 for this service. The price depends on where it is billed: about $1.02 from a physician practice, and about $3.16 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$1.02$0.93 to $1.12
FacilityA hospital or hospital-owned outpatient department$3.16$1.02 to $7.94

How much rates vary

Facilitymedian $3 · 10th to 90th $1 to $603Professionalmedian $1 · 10th to 90th $1 to $1
$1$10$100$1Kfacility $3professional $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
$0.39
Median
$0.41
Typical High
$0.41
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.02
Median
$1.02
Typical High
$933.25
BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.81
Median
$1.02
Typical High
$1.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.69
Median
$3.63
Typical High
$10.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.32
Typical High
$1.45
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$2.82
Median
$4.07
Typical High
$7.94
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$1.51
Medica
Setting
Facility
Modifier
Global
Typical Low
$0.69
Median
$1.86
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$1.26
Typical High
$1.26
United
Setting
Professional
Modifier
Global
Typical Low
$0.89
Median
$1.26
Typical High
$2.00

Where Minnesota 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.

Minnesota· 15th of 51

$1.02

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.