| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $869.15 | $869.15 | $869.15 | |
Providence
| Facility | $402.10 | $643.17 | $1,012.63 |
Initial Ped Critical Care 2 Thru 5 Years
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $869.15 | $869.15 | $869.15 | |
Providence
| Facility | $402.10 | $643.17 | $1,012.63 |