| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.33 | $0.89 | $0.89 | |
Anthem BCBS
| Professional | $1.11 | $1.11 | $1.30 | |
Cigna
| Professional | $0.42 | $0.42 | $0.42 | |
Martin's Point
| Professional | $0.33 | $0.89 | $0.89 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.33 | $0.89 | $0.89 | |
Anthem BCBS
| Professional | $1.11 | $1.11 | $1.30 | |
Cigna
| Professional | $0.42 | $0.42 | $0.42 | |
Martin's Point
| Professional | $0.33 | $0.89 | $0.89 |