| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.46 | $0.46 | $0.46 | |
Aetna
| Professional | $0.46 | $0.46 | $0.81 | |
Regence BlueShield
| Facility | $0.86 | $1.43 | $1.43 | |
United
| Professional | $0.50 | $1.08 | $1.25 |
Enteral Formula Nutritionally Incomplete/Modular Nutients Includes Specific Calories = 1 Unit (Special Coverage Instructions A
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.46 | $0.46 | $0.46 | |
Aetna
| Professional | $0.46 | $0.46 | $0.81 | |
Regence BlueShield
| Facility | $0.86 | $1.43 | $1.43 | |
United
| Professional | $0.50 | $1.08 | $1.25 |