| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $1.94 | $1.94 | $2.02 |
Enternal Formula For Pediatrics Nutritionally Complete Soy Based With Intact
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $1.94 | $1.94 | $2.02 |