| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.02 | $1.02 | $1.63 | |
BCBS
| Facility | $2.50 | $2.81 | $4.09 | |
BCBS
| Professional | $0.91 | $1.30 | $2.12 | |
United
| Professional | $0.83 | $1.85 | $2.21 |
Enteral Formula Nutritionally Complete Hydrolyzed Proteins (Amino Accis And Ing Tube 100 Calories = 1 Unit (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.02 | $1.02 | $1.63 | |
BCBS
| Facility | $2.50 | $2.81 | $4.09 | |
BCBS
| Professional | $0.91 | $1.30 | $2.12 | |
United
| Professional | $0.83 | $1.85 | $2.21 |