| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.00 | $3.98 | $6.03 | |
BCBS
| Professional | $8.91 | $8.91 | $9.55 | |
Medcost
| Facility | $0.72 | $0.72 | $0.87 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |
Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, 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
| Professional | $2.00 | $3.98 | $6.03 | |
BCBS
| Professional | $8.91 | $8.91 | $9.55 | |
Medcost
| Facility | $0.72 | $0.72 | $0.87 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |