| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1,320.00 | $1,320.00 | $1,320.00 |
Behavioral Health Treatments/Services (also see 091X, an extension of 090X)-Activity Therapy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1,320.00 | $1,320.00 | $1,320.00 |