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Pediatric Enteral Formula, Soy-Based, Intact Nutrients

South 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?

$1.38

Typical negotiated rate. In South Carolina, October 2026.

Insurers have agreed to pay about $1.38 for this service. Most negotiated rates run $1.38 to $1.38.

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 $1Professionalmedian $1 · 10th to 90th $0 to $1
$0.5$1facility $0professional $1

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 South Carolina
Setting
Professional
Modifier
None
Typical Low
$1.38
Median
$1.38
Typical High
$1.38
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
$0.49
Typical High
$0.55
Medcost
Setting
Professional
Modifier
None
Typical Low
$0.02
Median
$0.02
Typical High
$0.40

Where South 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.

South Carolina· 14th of 51

$1.38

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.