| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $87.87 | $87.87 | $109.09 | |
Cigna
| Professional | $193.11 | $242.82 | $286.49 | |
Kaiser Permanente
| Professional | $155.00 | $458.43 | $492.98 |
Prolonged service(s) in the outpatient setting requiring direct patient contact beyond the time of the usual service; each additional 30 minutes (List separately in addition to code for prolonged service)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $87.87 | $87.87 | $109.09 | |
Cigna
| Professional | $193.11 | $242.82 | $286.49 | |
Kaiser Permanente
| Professional | $155.00 | $458.43 | $492.98 |