Hospital Columbus, OH

Nationwide Children's Hospital

Nationwide Children's Hospital in Columbus, OH publishes cash prices for 68 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.

700 Children's Drive, Columbus, OH 43205 Collected Sep 22, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
CT scan of abdomen and pelvis, with contrast dye CPT 74177 ABDOMEN & PELIVS, W/ CONTRAST $2,421.00 $2,690.00 10%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ABDOMEN & PELIVS, W/ CONTRAST $2,421.00 $2,690.00 10%
CT scan of the head or brain, no contrast dye CPT 70450 HEAD/BRAIN W/O CONTRAST $1,035.00 $1,150.00 10%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HEAD/BRAIN W/O CONTRAST $1,035.00 $1,150.00 10%
CT scan of the pelvis, with contrast dye CPT 72193 PELVIS, W/ CONTRAST $1,494.00 $1,660.00 10%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 PELVIS, W/ CONTRAST $1,494.00 $1,660.00 10%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 EXTREMITY, LOWER, JOINT, W/O CONTRAST $2,367.00 $2,630.00 10%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 EXTREMITY, LOWER, JOINT, W/O CONTRAST $2,367.00 $2,630.00 10%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 EXTREMITY, LOWER, JOINT, W/ & W/O CONTRAST $3,672.00 $4,080.00 10%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 EXTREMITY, LOWER, JOINT, W/ & W/O CONTRAST $3,672.00 $4,080.00 10%
MRI of the brain, no contrast dye CPT 70551 BRAIN (INC BRAIN STEM), W/O CONTRAST $2,286.00 $2,540.00 10%
MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN (INC BRAIN STEM), W/O CONTRAST $2,286.00 $2,540.00 10%
MRI of the brain, with and without contrast dye CPT 70553 BRAIN (INCL BRAIN STEM), W/ & W/O CONTRAST $3,483.00 $3,870.00 10%
MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN (INCL BRAIN STEM), W/ & W/O CONTRAST $3,483.00 $3,870.00 10%
MRI of the lower back, no contrast dye CPT 72148 SPINE, LUMBAR, W/O CONTRAST $2,430.00 $2,700.00 10%
MRI of the lower back, no contrast dye inpatient CPT 72148 SPINE, LUMBAR, W/O CONTRAST $2,430.00 $2,700.00 10%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB FETAL & MATRNL EVAL, POST 1ST TRI $891.00 $990.00 10%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB FETAL & MATRNL EVAL, POST 1ST TRI $891.00 $990.00 10%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY, 6 YRS+, 4 OR MORE ADDL PARAM, W/ TECH $9,090.00 $10,100.00 10%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY, 6 YRS+, 4 OR MORE ADDL PARAM, W/ TECH $9,090.00 $10,100.00 10%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL, NON-OB $648.00 $720.00 10%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL, NON-OB $648.00 $720.00 10%
Ultrasound of the abdomen, complete CPT 76700 ABDOMEN, COMPLETE $774.00 $860.00 10%
Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMEN, COMPLETE $774.00 $860.00 10%
X-ray of the lower back, 4 or more views CPT 72110 SPINE, LUMBOSACRAL, MIN 4 VW $432.00 $480.00 10%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE, LUMBOSACRAL, MIN 4 VW $432.00 $480.00 10%

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL $93.60 $104.00 10%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL CALCIUM TOTAL $126.00 $140.00 10%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL $93.60 $104.00 10%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL CALCIUM TOTAL $126.00 $140.00 10%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL $134.10 $149.00 10%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL $134.10 $149.00 10%
Complete blood count (CBC) with differential CPT 85025 CBC W AUTO DIFF $43.20 $48.00 10%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W AUTO DIFF $43.20 $48.00 10%
Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFF $27.90 $31.00 10%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFF $27.90 $31.00 10%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL $143.10 $159.00 10%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL $148.50 $165.00 10%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL $143.10 $159.00 10%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL $148.50 $165.00 10%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL $117.00 $130.00 10%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL $117.00 $130.00 10%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL $358.20 $398.00 10%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL $358.20 $398.00 10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA $19.80 $22.00 10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA $19.80 $22.00 10%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT $84.60 $94.00 10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT $84.60 $94.00 10%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR $70.20 $78.00 10%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR $70.20 $78.00 10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE $27.00 $30.00 10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE $111.60 $124.00 10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE $27.00 $30.00 10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE $111.60 $124.00 10%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, AUTO WITH SCOPE $36.00 $40.00 10%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, AUTO WITH SCOPE $36.00 $40.00 10%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS, NON-AUTO WITH SCOPE $22.50 $25.00 10%
Urinalysis with microscope exam, manual CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY $22.50 $25.00 10%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS, NON-AUTO WITH SCOPE $22.50 $25.00 10%
Urinalysis without microscope exam, automated CPT 81003 URINE ANALYSIS DIPSTICK AUTOMATED $23.40 $26.00 10%
Urinalysis without microscope exam, automated CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY $23.40 $26.00 10%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE ANALYSIS DIPSTICK AUTOMATED $23.40 $26.00 10%
Urinalysis without microscope exam, manual CPT 81002 URINE, NON-AUTO, NO MICRO $23.40 $26.00 10%
Urinalysis without microscope exam, manual CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP $23.40 $26.00 10%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE, NON-AUTO, NO MICRO $23.40 $26.00 10%

Surgery and procedures

ProcedureCash price List priceOff list
Cataract surgery with lens implant CPT 66984 PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP $2,378.70 $2,643.00 10%
Cesarean delivery, including prenatal and postpartum care CPT 59510 PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM $12,165.30 $13,517.00 10%
Colonoscopy with endoscopic ultrasound CPT 45391 PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX $1,143.90 $1,271.00 10%
Colonoscopy with polyp removal CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $1,128.60 $1,254.00 10%
Colonoscopy with tissue sample CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $895.50 $995.00 10%
Colonoscopy, diagnostic CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $823.50 $915.00 10%
Gallbladder removal, laparoscopic CPT 47562 PR LAPAROSCOPY SURG CHOLECYSTECTOMY $3,012.30 $3,347.00 10%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $2,387.70 $2,653.00 10%
Knee arthroscopy with meniscus trim CPT 29881 PR ARTHRS KNEE SURG W/MENISCECTOMY MED/LAT W/SHVG $2,461.50 $2,735.00 10%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 POST CATARACT LASER SURGERY (YAG) $675.00 $750.00 10%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 PR POST-CATARACT LASER SURGERY $1,350.00 $1,500.00 10%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 POST CATARACT LASER SURGERY (YAG) $675.00 $750.00 10%
Left heart catheterization, diagnostic one side CPT 93452 LHC, INC LEFT VENTRICULOGRAPHY WHEN PERF $7,272.00 $8,080.00 10%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LHC, INC LEFT VENTRICULOGRAPHY WHEN PERF $7,272.00 $8,080.00 10%
Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $445.50 $495.00 10%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION, NON-NEUROLYTIC, INTERL EPID/SUBARACH, LUMBAR OR SACRA $1,827.00 $2,030.00 10%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION, NON-NEUROLYTIC, INTERL EPID/SUBARACH, LUMBAR OR SACRA $1,827.00 $2,030.00 10%
Lower-back epidural injection, without imaging guidance CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN $352.80 $392.00 10%
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION, INTERLAMINAR LUMBAR/SACRAL W/O IMAGE $1,467.00 $1,630.00 10%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION, INTERLAMINAR LUMBAR/SACRAL W/O IMAGE $1,467.00 $1,630.00 10%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $496.80 $552.00 10%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION; ANESTHETIC AGENT;TRANSFORAMINAL;LUMBAR OR SACRAL, SIN $954.00 $1,060.00 10%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION; ANESTHETIC AGENT;TRANSFORAMINAL;LUMBAR OR SACRAL, SIN $954.00 $1,060.00 10%
Prostate biopsy CPT 55700 PR PROSTATE NEEDLE BIOPSY ANY APPROACH $582.30 $647.00 10%
Prostate removal (prostatectomy), laparoscopic CPT 55866 PR LAPS SURG PRST8ECT RPBIC RAD W/NERVE SPARING $5,386.50 $5,985.00 10%
Removal of a breast lump, open surgery CPT 19120 PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION $1,902.60 $2,114.00 10%
Removal of a breast lump, open surgery CPT 19120 OPEN EXCISION OF BREAST MASS, MALE OR FEMALE, 1 OR MORE LESIONS $2,574.00 $2,860.00 10%
Removal of a breast lump, open surgery inpatient CPT 19120 OPEN EXCISION OF BREAST MASS, MALE OR FEMALE, 1 OR MORE LESIONS $2,574.00 $2,860.00 10%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS $775.80 $862.00 10%
Tonsil and adenoid removal, child under 12 CPT 42820 PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12 $1,319.40 $1,466.00 10%
Total hip replacement CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT $5,816.70 $6,463.00 10%
Total knee replacement CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS $5,808.60 $6,454.00 10%
Upper endoscopy (EGD) with biopsy CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $614.70 $683.00 10%
Upper endoscopy (EGD), diagnostic CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $547.20 $608.00 10%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB $11,474.10 $12,749.00 10%
Vaginal delivery, including prenatal and postpartum care CPT 59400 PR OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM $10,933.20 $12,148.00 10%

Doctor visits and therapy

ProcedureCash price List priceOff list
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $63.00 $70.00 10%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG $252.00 $280.00 10%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ECG $252.00 $280.00 10%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY W/PATIENT, 26+ MIN (90847) $256.50 $285.00 10%
Family therapy with the patient, 50 minutes CPT 90847 FAM THRPY W/PATIENT PER VISIT, 26+ MIN $279.00 $310.00 10%
Family therapy with the patient, 50 minutes CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $484.20 $538.00 10%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY W/PATIENT, 26+ MIN (90847) $256.50 $285.00 10%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAM THRPY W/PATIENT PER VISIT, 26+ MIN $279.00 $310.00 10%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY THERAPY W/O PATIENT, 26+ MIN (90846) $256.50 $285.00 10%
Family therapy without the patient, 50 minutes CPT 90846 FAM THPY W/O PATIENT PER VISIT, 26+ MIN $378.00 $420.00 10%
Family therapy without the patient, 50 minutes CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $464.40 $516.00 10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY THERAPY W/O PATIENT, 26+ MIN (90846) $256.50 $285.00 10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAM THPY W/O PATIENT PER VISIT, 26+ MIN $378.00 $420.00 10%
Group psychotherapy session CPT 90853 GROUP THERAPY (PATIENT GROUPS) (90853) $107.10 $119.00 10%
Group psychotherapy session CPT 90853 PR GROUP PSYCHOTHERAPY $114.30 $127.00 10%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY, NOT MULTI FAMILY $162.00 $180.00 10%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY (PATIENT GROUPS) (90853) $107.10 $119.00 10%
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY, NOT MULTI FAMILY $162.00 $180.00 10%
New patient office visit, about 30 minutes CPT 99203 99203-OFF VISIT NEW LVL 3 $266.40 $296.00 10%
New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $303.30 $337.00 10%
New patient office visit, about 30 minutes inpatient CPT 99203 99203-OFF VISIT NEW LVL 3 $266.40 $296.00 10%
New patient office visit, about 45 minutes CPT 99204 99204-OFF VISIT NEW LVL 4 $343.80 $382.00 10%
New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $493.20 $548.00 10%
New patient office visit, about 45 minutes inpatient CPT 99204 99204-OFF VISIT NEW LVL 4 $343.80 $382.00 10%
New patient office visit, about 60 minutes CPT 99205 99205-OFF VISIT NEW LVL 5 $443.70 $493.00 10%
New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $671.40 $746.00 10%
New patient office visit, about 60 minutes inpatient CPT 99205 99205-OFF VISIT NEW LVL 5 $443.70 $493.00 10%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES $83.70 $93.00 10%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE(S), EA 15 MIN $83.70 $93.00 10%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE(S), EA 15 MIN $83.70 $93.00 10%
Preventive checkup, new patient aged 18–39 CPT 99385 99385-PREV VISIT NEW 18-39YR $180.00 $200.00 10%
Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS $441.90 $491.00 10%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385-PREV VISIT NEW 18-39YR $180.00 $200.00 10%
Preventive checkup, new patient aged 40–64 CPT 99386 99386-PREV VISIT NEW 40-64YR $180.00 $200.00 10%
Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS $562.50 $625.00 10%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386-PREV VISIT NEW 40-64YR $180.00 $200.00 10%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 16-37 MIN W/PATIENT (90832) $107.10 $119.00 10%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 16-37 MIN W/ PATIENT $180.00 $200.00 10%
Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES $325.80 $362.00 10%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 16-37 MIN W/PATIENT (90832) $107.10 $119.00 10%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 16-37 MIN W/ PATIENT $180.00 $200.00 10%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 38-52 MIN, W/PATIENT (90834) $153.90 $171.00 10%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 38-52 MIN W/ PATIENT $333.00 $370.00 10%
Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES $429.30 $477.00 10%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 38-52 MIN, W/PATIENT (90834) $153.90 $171.00 10%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 38-52 MIN W/ PATIENT $333.00 $370.00 10%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 53+ MIN, W/PATIENT (90837) $200.70 $223.00 10%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 53+ MIN W/ PATIENT $459.00 $510.00 10%
Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES $636.30 $707.00 10%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 53+ MIN, W/PATIENT (90837) $200.70 $223.00 10%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 53+ MIN W/ PATIENT $459.00 $510.00 10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES $342.90 $381.00 10%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES $552.60 $614.00 10%

Source file: https://nationwidechildrens.pt.panaceainc.com/MRFDownload/nationwidechildrens/nationwidechildrens