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Calorically Dense Pediatric Enteral Formula

Iowa 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 does Calorically Dense Pediatric Enteral Formula cost?

$0.98

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $0.98 for this service. The price depends on where it is billed: about $0.76 from a physician practice, and about $1.07 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$0.76$0.34 to $0.98
FacilityA hospital or hospital-owned outpatient department$1.07$1.07 to $1.07

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $1Professionalmedian $1 · 10th to 90th $0 to $1
$0.5$2.0$10.0$50.0facility $1professional $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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1.07
Median
$1.07
Typical High
$1.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.34
Median
$0.34
Typical High
$1.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.76
Median
$0.93
Typical High
$0.95
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$1.78
Typical High
$151.36
Medica
Setting
Facility
Modifier
Global
Typical Low
$0.95
Median
$100.00
Typical High
$100.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$0.33
Median
$0.83
Typical High
$1.20
Midlands
Setting
Professional
Modifier
Global
Typical Low
$0.95
Median
$0.95
Typical High
$1.23
United
Setting
Facility
Modifier
Global
Typical Low
$0.49
Median
$0.49
Typical High
$0.49
United
Setting
Professional
Modifier
Global
Typical Low
$0.49
Median
$0.49
Typical High
$0.49
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$1.00
Typical High
$1.00

Where Iowa sits

The same service costs 4.6 times more in North Dakota than in Rhode Island. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Iowa $0.98 · 7th of 51
ND $1.51RI $0.33

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.