| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,258.93 | $1,258.93 | $1,258.93 |
Leave of Absence-Therapeutic Leave
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,258.93 | $1,258.93 | $1,258.93 |