| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $375.65 | $443.27 | $563.48 | |
Cigna
| Facility | $425.00 | $451.80 | $1,200.00 | |
Medical Mutual of Ohio
| Facility | $425.00 | $451.80 | $1,200.00 |
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 |
|---|---|---|---|---|---|
CareSource
| Facility | $375.65 | $443.27 | $563.48 | |
Cigna
| Facility | $425.00 | $451.80 | $1,200.00 | |
Medical Mutual of Ohio
| Facility | $425.00 | $451.80 | $1,200.00 |