| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Sanford Health Plan
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $513.00 | $513.00 | $513.00 |
Behavioral Health Treatments/Services (also see 091X, an extension of 090X)-Community Behavioral Health Program (Day Treatment)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Sanford Health Plan
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $513.00 | $513.00 | $513.00 |