| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.73 | $0.73 | $0.73 | |
Aetna
| Professional | $0.73 | $0.73 | $0.73 | |
CareFirst
| Professional | $3.56 | $3.56 | $3.56 |
Enternal Formula For Pediatrics Special Metabolic Needs For Inherited Disease
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.73 | $0.73 | $0.73 | |
Aetna
| Professional | $0.73 | $0.73 | $0.73 | |
CareFirst
| Professional | $3.56 | $3.56 | $3.56 |