| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $653.51 | $768.83 | $1,624.00 | |
Providence
| Facility | $539.22 | $768.83 | $1,624.00 |
Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Moda Health
| Facility | $653.51 | $768.83 | $1,624.00 | |
Providence
| Facility | $539.22 | $768.83 | $1,624.00 |