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Pediatric Enteral Formula, Soy-Based, Intact Nutrients

Ohio 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?

$1.86

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $1.86 for this service. Most negotiated rates run $0.95 to $1.86.

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.

How much rates vary

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

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
$1.86
Typical High
$1.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.41
Median
$1.86
Typical High
$1.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.71
Median
$1.20
Typical High
$1.91
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
$0.87
Typical High
$0.87
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$0.87
Median
$0.87
Typical High
$0.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$50.12
Typical High
$50.12
United
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$1.07
Typical High
$1.66

Where Ohio 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.

Ohio· 8th of 51

$1.86

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.