go back

Pediatric Enteral Formula, Soy-Based, Intact Nutrients

North Carolina 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?

$0.41

Typical negotiated rate. In North Carolina, October 2026.

Insurers have agreed to pay about $0.41 for this service. Most negotiated rates run $0.41 to $0.41.

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.

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $0Professionalmedian $0 · 10th to 90th $0 to $2
$0.5$1$2$5$10$20$50facility $0professional $0

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
$0.41
Median
$0.41
Typical High
$0.41
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.41
Median
$0.41
Typical High
$0.41
BCBS North Carolina
Setting
Professional
Modifier
None
Typical Low
$2.24
Median
$2.24
Typical High
$2.40
Cigna
Setting
Professional
Modifier
None
Typical Low
$0.87
Median
$0.87
Typical High
$0.87
Medcost
Setting
Facility
Modifier
None
Typical Low
$0.41
Median
$0.41
Typical High
$1.86
Medcost
Setting
Professional
Modifier
None
Typical Low
$1.29
Median
$1.29
Typical High
$1.29

Where North Carolina 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.

North Carolina· 50th of 51

$0.41

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.