| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $3,715.35 | $3,715.35 | $4,897.79 | |
Sanford Health Plan
| Facility | $100.00 | $100.00 | $100.00 |
Intensive Care - Pediatric
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $3,715.35 | $3,715.35 | $4,897.79 | |
Sanford Health Plan
| Facility | $100.00 | $100.00 | $100.00 |