| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.92 | $0.92 | $0.92 | |
Aetna
| Professional | $0.92 | $0.92 | $1.46 | |
Regence BlueShield
| Facility | $1.72 | $1.90 | $2.54 | |
United
| Professional | $0.80 | $1.85 | $2.44 |
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
| Facility | $0.92 | $0.92 | $0.92 | |
Aetna
| Professional | $0.92 | $0.92 | $1.46 | |
Regence BlueShield
| Facility | $1.72 | $1.90 | $2.54 | |
United
| Professional | $0.80 | $1.85 | $2.44 |