| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $242.82 | $356.65 | $427.30 | |
Molina
| Professional | $85.40 | $85.40 | $85.40 |
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 |
|---|---|---|---|---|---|
Cigna
| Professional | $242.82 | $356.65 | $427.30 | |
Molina
| Professional | $85.40 | $85.40 | $85.40 |