| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Facility | $1,073.63 | $2,100.00 | $2,537.35 |
Professional Fees (Extension of 096X)-Occupational Therapy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Facility | $1,073.63 | $2,100.00 | $2,537.35 |