| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $1.20 | $1.20 | $1.26 | |
United
| Professional | $1.32 | $1.32 | $1.47 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $1.20 | $1.20 | $1.26 | |
United
| Professional | $1.32 | $1.32 | $1.47 |