| 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 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 | $1.57 | $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 |