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Pediatric Hydrolyzed or Amino Acid Enteral Formula

Virginia 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?

$1.86

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $1.86 for this service. The price depends on where it is billed: about $1.86 from a physician practice, and about $2.69 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$1.86$1.12 to $2.69
FacilityA hospital or hospital-owned outpatient department$2.69$1.95 to $2.95

How much rates vary

Facilitymedian $3 · 10th to 90th $1 to $10,000Professionalmedian $2 · 10th to 90th $1 to $3
$1$10$100$1K$10Kfacility $3professional $2

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
$1.12
Median
$2.69
Typical High
$2.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$2.69
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.86
Median
$1.86
Typical High
$2.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.04
Median
$2.04
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.74
Median
$1.74
Typical High
$1.74
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$8.91
Median
$8.91
Typical High
$15.85
Medcost
Setting
Facility
Modifier
Global
Typical Low
$1.20
Median
$2.82
Typical High
$3.24
Sentara
Setting
Facility
Modifier
Global
Typical Low
$1.95
Median
$2.69
Typical High
$10,964.78
Sentara
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$2.69
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$2.04
Median
$2.04
Typical High
$2.04

Where Virginia 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.

Virginia· 15th of 51

$1.86

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.