| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
AmeriHealth
| Professional | $134.81 | $134.81 | $134.81 | |
Cigna
| Professional | $272.30 | $367.79 | $624.97 | |
Horizon BCBS
| Professional | $92.91 | $119.14 | $201.83 |
Prolonged service(s) in the outpatient setting requiring direct patient contact beyond the time of the usual service; first hour (List separately in addition to code for outpatient Evaluation and Management or psychotherapy service, except with office or other outpatient services [99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215])
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
AmeriHealth
| Professional | $134.81 | $134.81 | $134.81 | |
Cigna
| Professional | $272.30 | $367.79 | $624.97 | |
Horizon BCBS
| Professional | $92.91 | $119.14 | $201.83 |