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Calorically Dense Pediatric Enteral Formula

Ohio 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?

$0.98

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $0.98 for this service. Most negotiated rates run $0.71 to $0.98.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1 · 10th to 90th $0 to $1Professionalmedian $1 · 10th to 90th $0 to $1
$0.5$1$2$5$10$20$50facility $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
$0.34
Median
$0.98
Typical High
$0.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.34
Median
$0.98
Typical High
$0.98
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.65
Median
$0.81
Typical High
$1.23
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
$0.42
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$0.42
Median
$0.42
Typical High
$0.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$50.12
Typical High
$50.12
United
Setting
Professional
Modifier
Global
Typical Low
$0.59
Median
$0.59
Typical High
$0.95

Where Ohio sits

The same service costs 4.6 times more in North Dakota than in Rhode Island. 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.

Ohio· 5th of 51

$0.98

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.