Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or 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
| Facility | $0.51 | $0.51 | $0.51 | |
Aetna
| Professional | $0.51 | $0.66 | $0.92 | |
Anthem BCBS
| Facility | $0.62 | $0.80 | $0.92 | |
Anthem BCBS
| Professional | $0.70 | $0.70 | $0.70 | |
United
| Professional | $0.38 | $1.20 | $1.47 |