| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $135.00 | $492.00 | $600.00 | |
Ambetter
| Facility | $175.00 | $175.00 | $175.00 | |
Cigna
| Facility | $140.00 | $251.00 | $365.00 | |
United
| Facility | $472.00 | $472.00 | $472.00 |
Behavioral Health Treatments/Services (also see 091X, an extension of 090X)-Intensive Outpatient Services-Chemical Dependency
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $135.00 | $492.00 | $600.00 | |
Ambetter
| Facility | $175.00 | $175.00 | $175.00 | |
Cigna
| Facility | $140.00 | $251.00 | $365.00 | |
United
| Facility | $472.00 | $472.00 | $472.00 |