| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $823.00 | $914.00 | $962.00 | |
Kaiser Permanente
| Facility | $763.44 | $763.44 | $763.44 | |
Sentara
| Facility | $19.89 | $4,071.00 | $10,945.00 |
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 | $823.00 | $914.00 | $962.00 | |
Kaiser Permanente
| Facility | $763.44 | $763.44 | $763.44 | |
Sentara
| Facility | $19.89 | $4,071.00 | $10,945.00 |