go back

Calorically Dense Pediatric Enteral Formula

Minnesota 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 $2 · 10th–90th $1$5130%20%10th90th$2Professionalmedian $1 · 10th–90th $1$20%20%40%10th90th$1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$0.34
Median
$0.34
Typical High
$0.34
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.32
Median
$0.34
Typical High
$0.34
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.58
Median
$1.62
Typical High
$933.25
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.62
Typical High
$1.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.78
Median
$2.45
Typical High
$6.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.76
Median
$0.87
Typical High
$0.95
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$1.86
Median
$2.69
Typical High
$5.25
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$0.76
Median
$0.76
Typical High
$1.02
Medica
Setting
Facility
Modifier
Global
Typical Low
$0.56
Median
$1.07
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$0.71
Median
$0.71
Typical High
$0.71
United
Setting
Professional
Modifier
Global
Typical Low
$0.49
Median
$0.71
Typical High
$1.07