| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $11,385.90 | $11,385.90 | $11,385.90 | |
Sanford Health Plan
| Facility | $950.00 | $950.00 | $950.00 |
Extreme Immaturity or Respiratory Distress Syndrome, Neonate
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $11,385.90 | $11,385.90 | $11,385.90 | |
Sanford Health Plan
| Facility | $950.00 | $950.00 | $950.00 |