| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $3,630.78 | $3,630.78 | $11,481.54 |
Intensive Care - Pediatric
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $3,630.78 | $3,630.78 | $11,481.54 |