| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1,648.00 | $1,648.00 | $1,648.00 |
Behavioral Health Treatment/Services-Extension of 090X - Rehabilitation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $1,648.00 | $1,648.00 | $1,648.00 |