Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Additive for enteral formula
Low
$0
Average
$10
Median
$0
High
$791
Filter by billing methodology
Prices here combine facility and professional fees. See them separately →Experimental
Reflects negotiated fee schedule rates with commercial payers.
Showing only prices reported under the fee schedule methodology. Choose another in the filter above to change the chart. 332 hospitals; the 90th percentile is 142.7× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | St. Anthony Shawnee Hospital, Inc Shawnee, OK | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Beth Israel Deaconess Hospital - Needham Needham, MA | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Fairview Health Services Edina, MN | $2 | $100 | $207 | 206% | — | $0 – $610 |
| 4 | Mayo Regional Hospital Dover Foxcroft, ME | $1 | $1 | $1 | 68% | — | $0 – $1 |
| 5 | Hoopeston Community Memorial Hospital Hoopeston, IL | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Newark-Wayne Community Hospital Newark, NY | $0 | $0 | $0 | 14% | — | $0 – $0 |
| 7 | William Beaumont Hospital Grosse Pointe, MI | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Westfield Memorial Hospital Inc WESTFIELD, NY | $0 | $0 | $0 | 33% | — | $0 – $0 |
| 9 | Sanford USD Medical Center Sioux Falls, SD | $4 | $9 | $6 | 70% | — | $4 – $16 |
| 10 | Munson Healthcare Charlevoix Hospital Charlevoix, MI | $0 | $0 | — | — | — | $0 – $0 |
Ask Claude or any MCP client for HCPCS B4104 pricing at a specific hospital — see how to connect.