| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Professional | $54.95 | $77.62 | $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 |
|---|---|---|---|---|---|
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Professional | $54.95 | $77.62 | $134.90 |