| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $368.07 | $368.07 | $368.07 | |
Hometown Health
| Professional | $3.25 | $400.00 | $562.76 |
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 |
|---|---|---|---|---|---|
Aetna
| Facility | $368.07 | $368.07 | $368.07 | |
Hometown Health
| Professional | $3.25 | $400.00 | $562.76 |