| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $363.00 | $363.00 | $363.00 | |
Martin's Point
| Facility | $363.00 | $363.00 | $363.00 |
Other Therapeutic Services (see also 095X, an extension of 094X)-Alcohol Rehabilitation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $363.00 | $363.00 | $363.00 | |
Martin's Point
| Facility | $363.00 | $363.00 | $363.00 |