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Calorically Dense Pediatric Enteral Formula

North Dakota 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 $1 · 10th–90th $0$10%50%10th$1Professionalmedian $2 · 10th–90th $1$20%20%10th90th$2$0.5$1.0$2.0

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
Facility
Modifier
Global
Typical Low
$0.34
Median
$0.89
Typical High
$0.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.34
Median
$0.89
Typical High
$0.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.35
Median
$1.55
Typical High
$1.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.76
Median
$0.76
Typical High
$0.93
Medica
Setting
Facility
Modifier
Global
Typical Low
$0.89
Median
$0.89
Typical High
$2.69
Medica
Setting
Professional
Modifier
Global
Typical Low
$0.59
Median
$0.59
Typical High
$0.59
United
Setting
Professional
Modifier
Global
Typical Low
$0.59
Median
$0.59
Typical High
$1.07