| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.00 | $125.00 | $125.00 | |
Ambetter
| Facility | $192.14 | $192.14 | $192.14 |
Behavioral Health Treatments/Services (also see 091X, an extension of 090X)-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.00 | $125.00 | $125.00 | |
Ambetter
| Facility | $192.14 | $192.14 | $192.14 |