| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.40 | $0.40 | $0.40 | |
Aetna
| Professional | $0.40 | $0.40 | $0.41 |
Enternal Formula For Pediatrics Nutritionally Complete With Intact Nutrients
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.40 | $0.40 | $0.40 | |
Aetna
| Professional | $0.40 | $0.40 | $0.41 |