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Calorically Dense Pediatric Enteral Formula

Virginia 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?

$0.85

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $0.85 for this service. The price depends on where it is billed: about $0.85 from a physician practice, and about $0.85 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 7 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$0.85$0.34 to $1.05
FacilityA hospital or hospital-owned outpatient department$0.85$0.44 to $1.07

How much rates vary

Facilitymedian $1 · 10th to 90th $0 to $10,000Professionalmedian $1 · 10th to 90th $0 to $1
$1$10$100$1K$10Kfacility $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
$0.85
Typical High
$0.85
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.33
Median
$0.34
Typical High
$0.85
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$1.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$0.49
Median
$0.49
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.42
Median
$0.42
Typical High
$0.42
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$2.00
Median
$2.00
Typical High
$3.02
Medcost
Setting
Facility
Modifier
Global
Typical Low
$0.36
Median
$0.91
Typical High
$1.07
Sentara
Setting
Facility
Modifier
Global
Typical Low
$0.45
Median
$4,073.80
Typical High
$10,964.78
Sentara
Setting
Professional
Modifier
Global
Typical Low
$0.45
Median
$4,073.80
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$0.65
Median
$0.65
Typical High
$0.65

Where Virginia 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.

Virginia· 16th of 51

$0.85

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.