| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $1.00 | $1.00 | |
Cigna
| Professional | $1.91 | $1.91 | $2.45 | |
United
| Professional | $0.55 | $2.34 | $2.82 |
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 | $1.00 | |
Cigna
| Professional | $1.91 | $1.91 | $2.45 | |
United
| Professional | $0.55 | $2.34 | $2.82 |