| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Prolonged Svc Outpatient Setting Ea Addl 30 Min
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $30.00 | $30.00 | $30.00 |