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Calorically Dense Pediatric Enteral Formula

New York 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%20%10th90th$1Professionalmedian $1 · 10th–90th $0$10%20%10th90th$1$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$0.26
Median
$0.34
Typical High
$0.34
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.33
Median
$0.34
Typical High
$0.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.91
Median
$1.17
Typical High
$1.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.42
Median
$0.42
Typical High
$4.79
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$0.85
Median
$1.07
Typical High
$1.10
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$0.62
Median
$0.62
Typical High
$0.83
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.72
Median
$0.83
Typical High
$0.83
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$1.32
Median
$50,118.72
Typical High
$75,857.76
United
Setting
Professional
Modifier
Global
Typical Low
$1.10
Median
$1.10
Typical High
$64.57
Univera
Setting
Facility
Modifier
Global
Typical Low
$0.62
Median
$0.89
Typical High
$0.89
Univera
Setting
Professional
Modifier
Global
Typical Low
$0.72
Median
$0.83
Typical High
$0.91