| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $215.00 | $215.00 | $215.00 | |
Ambetter
| Facility | $206.32 | $206.32 | $206.32 |
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 | $215.00 | $215.00 | $215.00 | |
Ambetter
| Facility | $206.32 | $206.32 | $206.32 |