| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $211.70 | $344.39 | $427.30 | |
Molina
| Professional | $89.69 | $89.69 | $89.69 |
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 | $211.70 | $344.39 | $427.30 | |
Molina
| Professional | $89.69 | $89.69 | $89.69 |