| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $193.11 | $342.59 | $427.30 | |
Medcost
| Professional | $121.00 | $121.00 | $124.43 | |
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 |
|---|---|---|---|---|---|
Cigna
| Professional | $193.11 | $342.59 | $427.30 | |
Medcost
| Professional | $121.00 | $121.00 | $124.43 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |