| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $478.63 | $758.58 | |
Fallon Health
| Facility | $60.26 | $3,630.78 | $9,772.37 | |
United
| Facility | $173.78 | $173.78 | $173.78 |
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 | $162.18 | $478.63 | $758.58 | |
Fallon Health
| Facility | $60.26 | $3,630.78 | $9,772.37 | |
United
| Facility | $173.78 | $173.78 | $173.78 |