| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.00 | $125.00 | $125.00 |
Behavioral Health Treatments/Services Extension of 090X-Other Behavioral Health Treatments/Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.00 | $125.00 | $125.00 |