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Pediatric Hydrolyzed or Amino Acid Enteral Formula

Washington 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?

$1.12

Typical negotiated rate. In Washington, July 2026.

Insurers have agreed to pay about $1.12 for this service. The price depends on where it is billed: about $1.12 from a physician practice, and about $2.29 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 6 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$1.12$1.12 to $1.12
FacilityA hospital or hospital-owned outpatient department$2.29$2.29 to $5.25

How much rates vary

Facilitymedian $2 · 10th to 90th $1 to $6Professionalmedian $1 · 10th to 90th $1 to $2
$2$5$10facility $2professional $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
$1.12
Median
$1.12
Typical High
$1.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$1.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.74
Median
$1.74
Typical High
$1.74
Molina
Setting
Professional
Modifier
Global
Typical Low
$2.29
Median
$2.51
Typical High
$75.86
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$2.29
Typical High
$2.29
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.47
Median
$5.50
Typical High
$7.76
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$1.95
Typical High
$3.47

Where Washington 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.

Washington· 35th of 51

$1.12

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.