| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $8,709.64 | $8,709.64 | $8,709.64 |
Room & Board - Private - Pediatric
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $8,709.64 | $8,709.64 | $8,709.64 |