| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $27.00 | $34.20 | $39.53 |
Hlth&Behavior Assmt Ea 15 Min W/Pt Re-Assmt
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $27.00 | $34.20 | $39.53 |