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Pediatric Enteral Formula, Soy-Based, Intact Nutrients

Vermont 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 rates vary

Professionalmedian $0 · 10th to 90th $0 to $0
$0.5professional $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
Professional
Modifier
Global
Typical Low
$0.40
Median
$0.40
Typical High
$0.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.87
Median
$0.87
Typical High
$0.87