| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.26 | $0.26 | $0.88 | |
Aetna
| Professional | $0.26 | $0.34 | $0.88 | |
Cigna
| Professional | $0.42 | $0.42 | $0.42 | |
Horizon BCBS
| Professional | $0.69 | $0.81 | $0.81 |
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
| Facility | $0.26 | $0.26 | $0.88 | |
Aetna
| Professional | $0.26 | $0.34 | $0.88 | |
Cigna
| Professional | $0.42 | $0.42 | $0.42 | |
Horizon BCBS
| Professional | $0.69 | $0.81 | $0.81 |