| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.72 | $0.72 | $0.72 | |
Aetna
| Professional | $0.72 | $0.73 | $4.01 | |
Anthem BCBS
| Professional | $2.47 | $2.47 | $2.47 |
Enternal Formula For Pediatrics Special Metabolic Needs For Inherited Disease
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.72 | $0.72 | $0.72 | |
Aetna
| Professional | $0.72 | $0.73 | $4.01 | |
Anthem BCBS
| Professional | $2.47 | $2.47 | $2.47 |