Calorically Dense Pediatric Enteral Formula

Hawaii 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.

How much rates vary

Professionalmedian $1 · 10th to 90th $1 to $1

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	Facility/Professional	Modifier	Typical Low	Median	Typical High
HMSA Setting Professional Modifier Global Typical Low $1.07 Median $1.07 Typical High $1.07	Professional	Global	$1.07	$1.07	$1.07