| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $686.38 | $686.38 | $686.38 |
Behavioral Health Treatments/Services Extension of 090X-Testing
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $686.38 | $686.38 | $686.38 |