| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.55 | $1.55 | $1.55 | |
BCBS
| Professional | $2.52 | $2.97 | $2.97 | |
United
| Professional | $0.81 | $2.24 | $5.52 |
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 | $1.55 | $1.55 | $1.55 | |
BCBS
| Professional | $2.52 | $2.97 | $2.97 | |
United
| Professional | $0.81 | $2.24 | $5.52 |