| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.57 | $1.57 | $1.57 | |
Cigna
| Professional | $1.92 | $1.92 | $2.47 | |
MVP Health Care
| Professional | $1.92 | $1.92 | $1.92 | |
United
| Professional | $0.81 | $2.68 | $2.84 |
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 | $1.57 | $1.57 | $1.57 | |
Cigna
| Professional | $1.92 | $1.92 | $2.47 | |
MVP Health Care
| Professional | $1.92 | $1.92 | $1.92 | |
United
| Professional | $0.81 | $2.68 | $2.84 |