| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $691.94 | $691.94 | $691.94 |
Initial Ped Critical Care 2 Thru 5 Years
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $691.94 | $691.94 | $691.94 |