| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.76 | $1.76 | $1.76 | |
Aetna
| Professional | $0.73 | $1.76 | $1.76 |
Enternal Formula For Pediatrics Special Metabolic Needs For Inherited Disease
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.76 | $1.76 | $1.76 | |
Aetna
| Professional | $0.73 | $1.76 | $1.76 |