| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $413.18 | $413.18 | $413.18 |
Subsequent Ped Critical Care 2 Thru 5 Years
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $413.18 | $413.18 | $413.18 |