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Calorically Dense Pediatric Enteral Formula

Montana 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 October 2026.

How much does Calorically Dense Pediatric Enteral Formula cost?

$79.43

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $79.43 for this service. Most negotiated rates run $79.43 to $79.43.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $79 · 10th to 90th $1 to $79
$0.5$1$2$5$10$20$50professional $79

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.34
Median
$0.34
Typical High
$0.34
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$0.56
Median
$0.56
Typical High
$0.56
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$79.43
Typical High
$79.43

Where Montana sits

The same service costs 239.9 times more in Montana than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 1st of 51

$79.43

MT $79.43UT $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.