| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.12 | $1.12 | $1.13 | |
BCBS
| Facility | $1.42 | $2.77 | $3.21 | |
BCBS
| Professional | $0.99 | $1.42 | $2.31 |
Enternal Formula For Pediatrics Hydrolyzed/Amino Acids And Peptide Chain
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.12 | $1.12 | $1.13 | |
BCBS
| Facility | $1.42 | $2.77 | $3.21 | |
BCBS
| Professional | $0.99 | $1.42 | $2.31 |