| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,740.00 | $3,740.00 | $106,930.00 | |
United
| Facility | $3,776.00 | $3,776.00 | $5,552.00 |
Special Charges - Late Discharge, medically necessary
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,740.00 | $3,740.00 | $106,930.00 | |
United
| Facility | $3,776.00 | $3,776.00 | $5,552.00 |