| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.53 | $331.13 | $575.44 | |
Molina
| Facility | $1,023.29 | $1,023.29 | $1,023.29 | |
United
| Facility | $275.42 | $275.42 | $323.59 |
Other Therapeutic Services (see also 095X, an extension of 094X)-Drug Rehabilitation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.53 | $331.13 | $575.44 | |
Molina
| Facility | $1,023.29 | $1,023.29 | $1,023.29 | |
United
| Facility | $275.42 | $275.42 | $323.59 |