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Calorically Dense Pediatric Enteral Formula

California rates for HCPCS B4160

Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Rates data updated July 2026.

Facilitymedian $1 · 10th–90th $1$10%20%10th90th$1Professionalmedian $0 · 10th–90th $0$20%50%10th90th$0$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.33
Median
$0.33
Typical High
$0.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.33
Median
$0.33
Typical High
$0.34
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$0.87
Median
$0.98
Typical High
$1.12
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.79
Median
$1.12
Typical High
$1.17
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$0.91
Median
$1.62
Typical High
$39.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.42
Median
$0.42
Typical High
$0.42
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$1.00
Typical High
$398.11
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$2.40
Median
$2.40
Typical High
$2.40
Providence
Setting
Facility
Modifier
Global
Typical Low
$0.34
Median
$0.47
Typical High
$1.07
Providence
Setting
Professional
Modifier
Global
Typical Low
$0.33
Median
$0.42
Typical High
$0.42
United
Setting
Professional
Modifier
Global
Typical Low
$3.39
Median
$3.39
Typical High
$3.39