| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,178.00 | $1,178.00 | $1,350.00 | |
Kaiser Permanente
| Facility | $1,405.00 | $7,775.00 | $400,000.00 |
Leave Of Absence - Icf/Mr - Any Reason
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,178.00 | $1,178.00 | $1,350.00 | |
Kaiser Permanente
| Facility | $1,405.00 | $7,775.00 | $400,000.00 |