go back

Calorically Dense Pediatric Enteral Formula

Maine 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.

Professionalmedian $1 · 10th–90th $0$10%20%10th90th$1$0.5$1.0

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
Professional
Modifier
Global
Typical Low
$0.26
Median
$0.33
Typical High
$0.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$1.17
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.42
Median
$0.42
Typical High
$0.42
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$0.26
Median
$0.89
Typical High
$0.98