| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $350.00 | $350.00 | $350.00 | |
Hometown Health
| Facility | $335.00 | $335.00 | $335.00 |
Behavioral Health Treatments/Services Extension of 090X-Rehabilitation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $350.00 | $350.00 | $350.00 | |
Hometown Health
| Facility | $335.00 | $335.00 | $335.00 |