| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Optum
| Facility | $186.21 | $186.21 | $316.23 | |
United
| Facility | $186.21 | $186.21 | $316.23 |
Behavioral Health Treatments/Services Extension of 090X-Other Behavioral Health Treatments/Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Optum
| Facility | $186.21 | $186.21 | $316.23 | |
United
| Facility | $186.21 | $186.21 | $316.23 |