| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $1.00 | $1.00 | |
BCBS
| Professional | $0.87 | $1.02 | $1.02 | |
United
| Facility | $0.68 | $0.68 | $0.85 | |
United
| Professional | $0.48 | $1.38 | $3.55 |
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 | |
BCBS
| Professional | $0.87 | $1.02 | $1.02 | |
United
| Facility | $0.68 | $0.68 | $0.85 | |
United
| Professional | $0.48 | $1.38 | $3.55 |