| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $95.50 | $95.50 | $95.50 |
Behavioral Health Treatments/Services Extension of 090X-Rehabilitation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $95.50 | $95.50 | $95.50 |