| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.13 | $1.13 | $1.13 | |
Aetna
| Professional | $1.12 | $1.13 | $1.13 | |
BCBS
| Professional | $2.65 | $2.65 | $2.65 | |
Cigna
| Professional | $1.74 | $1.74 | $2.11 |
Enternal Formula For Pediatrics Hydrolyzed/Amino Acids And Peptide Chain
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.13 | $1.13 | $1.13 | |
Aetna
| Professional | $1.12 | $1.13 | $1.13 | |
BCBS
| Professional | $2.65 | $2.65 | $2.65 | |
Cigna
| Professional | $1.74 | $1.74 | $2.11 |