| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $554.03 | $565.90 | $565.90 | |
Medica
| Facility | $247.65 | $408.82 | $643.90 | |
United
| Facility | $456.95 | $456.95 | $456.95 |
Subsequent Ped Critical Care 2 Thru 5 Years
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $554.03 | $565.90 | $565.90 | |
Medica
| Facility | $247.65 | $408.82 | $643.90 | |
United
| Facility | $456.95 | $456.95 | $456.95 |