| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $28,874.72 | $39,374.61 | $44,999.55 | |
CareSource
| Professional | $34,124.66 | $34,124.66 | $36,749.62 | |
Cigna
| Professional | $242.82 | $377.53 | $452.33 |
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 |
|---|---|---|---|---|---|
CareSource
| Facility | $28,874.72 | $39,374.61 | $44,999.55 | |
CareSource
| Professional | $34,124.66 | $34,124.66 | $36,749.62 | |
Cigna
| Professional | $242.82 | $377.53 | $452.33 |