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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.

How much does Calorically Dense Pediatric Enteral Formula cost?

$0.91

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $0.91 for this service. The price depends on where it is billed: about $0.91 from a physician practice, and about $0.62 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$0.91$0.34 to $1.17
FacilityA hospital or hospital-owned outpatient department$0.62$0.34 to $0.89

How much rates vary

Facilitymedian $1 · 10th to 90th $0 to $1Professionalmedian $1 · 10th to 90th $0 to $1
$1.0$10.0$100.0$1.0K$10.0Kfacility $1professional $1

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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

Where New York sits

The same service costs 4.6 times more in North Dakota than in Rhode Island. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

New York $0.91 · 12th of 51
ND $1.51RI $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.