| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $5,888.44 | $5,888.44 | $5,888.44 |
Intensive Care - Pediatric
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $5,888.44 | $5,888.44 | $5,888.44 |