HCPCS B4159
Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit
Current code18 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $2.91 – $3.31 | — | — |
| Deaconess Medical Center | $2.24 – $2.91 | — | — |
| Mary Bridge Children's Hospital | $2.91 – $3.94 | — | — |
| MultiCare Auburn Medical Center | $2.91 – $3.94 | — | — |
| MultiCare Covington Medical Center | $2.91 – $3.94 | — | — |
| MultiCare Good Samaritan Hospital | $2.91 – $3.94 | — | — |
| MultiCare Valley Hospital | $2.24 – $2.91 | — | — |
| Overlake Hospital Medical Center & Clinics | $3.33 – $3.70 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1.39 | — | — |
| Providence Holy Family Hospital | $1.39 | — | — |
| Providence Regional Medical Center Everett | $1.39 | — | — |
| Swedish Edmonds Hospital | $1.39 | — | — |
| Swedish Issaquah | $1.39 | — | — |
| Swedish Medical Center | $1.39 | — | — |
| Swedish Medical Center / Cherry Hill | $1.39 | — | — |
| Tacoma General Allenmore Hospital | $2.91 – $3.94 | — | — |
| Virginia Mason Medical Center | $4.84 | — | — |
| Yakima Valley Memorial | $2.77 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.