| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $213.80 | $288.40 | $426.58 | |
Molina
| Professional | $85.11 | $85.11 | $85.11 | |
United
| Facility | $0.10 | $77.62 | $95.50 | |
United
| Professional | $66.07 | $89.13 | $134.90 |
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 | $213.80 | $288.40 | $426.58 | |
Molina
| Professional | $85.11 | $85.11 | $85.11 | |
United
| Facility | $0.10 | $77.62 | $95.50 | |
United
| Professional | $66.07 | $89.13 | $134.90 |