| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $423.00 | $423.00 | $423.00 |
Behavioral Health Treatment/Services (Also See 091X, An Extension Of 090X) - Milieu Therapy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $423.00 | $423.00 | $423.00 |