| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.34 | $0.34 | $0.75 | |
Cigna
| Professional | $1.80 | $1.80 | $1.80 | |
United
| Professional | $0.87 | $1.19 | $1.88 |
Enteral Formulae Nutritionally Complete For Special Metabolic Needs Excludes Nteral Feeding Tube 100 Calories = 1 Unit (Special Coverage Instructions Apply. See Cim: 65-10 And
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.34 | $0.34 | $0.75 | |
Cigna
| Professional | $1.80 | $1.80 | $1.80 | |
United
| Professional | $0.87 | $1.19 | $1.88 |