| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $1.00 | $1.00 | |
Cigna
| Professional | $0.95 | $0.95 | $1.82 | |
United
| Professional | $0.32 | $1.51 | $1.82 |
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
| Professional | $1.00 | $1.00 | $1.00 | |
Cigna
| Professional | $0.95 | $0.95 | $1.82 | |
United
| Professional | $0.32 | $1.51 | $1.82 |