| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.40 | $0.40 | $0.41 | |
BCBS
| Facility | $0.50 | $0.98 | $1.12 | |
BCBS
| Professional | $0.35 | $0.50 | $0.81 |
Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.40 | $0.40 | $0.41 | |
BCBS
| Facility | $0.50 | $0.98 | $1.12 | |
BCBS
| Professional | $0.35 | $0.50 | $0.81 |