| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $1.00 | $4.90 | |
BCBS
| Facility | $2.51 | $2.88 | $4.07 | |
BCBS
| Professional | $0.83 | $0.98 | $1.91 | |
United
| Professional | $0.83 | $1.86 | $2.45 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $1.00 | $4.90 | |
BCBS
| Facility | $2.51 | $2.88 | $4.07 | |
BCBS
| Professional | $0.83 | $0.98 | $1.91 | |
United
| Professional | $0.83 | $1.86 | $2.45 |