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Pediatric Hydrolyzed or Amino Acid Enteral Formula

New York rates for HCPCS B4161

Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes 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 Pediatric Hydrolyzed or Amino Acid Enteral Formula cost?

$2.51

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $2.51 for this service. The price depends on where it is billed: about $2.51 from a physician practice, and about $2.09 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 9 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$2.51$1.12 to $2.63
FacilityA hospital or hospital-owned outpatient department$2.09$1.12 to $2.95

How much rates vary

Facilitymedian $2 · 10th to 90th $1 to $3Professionalmedian $3 · 10th to 90th $1 to $3
$1$10$100$1K$10Kfacility $2professional $3

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
$0.89
Median
$1.12
Typical High
$1.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$2.82
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.63
Typical High
$3.80
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$2.24
Median
$2.24
Typical High
$2.45
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$2.24
Median
$2.24
Typical High
$2.24
Cigna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.74
Median
$1.74
Typical High
$14.79
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$2.82
Median
$2.88
Typical High
$3.09
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$2.09
Median
$2.09
Typical High
$2.51
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.09
Median
$2.24
Typical High
$2.24
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$4.57
Median
$50,118.72
Typical High
$75,857.76
United
Setting
Professional
Modifier
Global
Typical Low
$2.88
Median
$2.88
Typical High
$64.57
Univera
Setting
Facility
Modifier
Global
Typical Low
$2.09
Median
$2.95
Typical High
$2.95
Univera
Setting
Professional
Modifier
Global
Typical Low
$2.09
Median
$2.24
Typical High
$2.95

Where New York sits

The same service costs 3.0 times more in Hawaii than in North Carolina. 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.

New York· 12th of 51

$2.51

HI $3.39NC $1.12

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.