| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $125.89 | $162.18 | $173.78 | |
United
| Professional | $75.86 | $75.86 | $75.86 |
Prolonged service in the inpatient or observation setting, requiring unit/floor time beyond 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 |
|---|---|---|---|---|---|
Pacific Source
| Facility | $125.89 | $162.18 | $173.78 | |
United
| Professional | $75.86 | $75.86 | $75.86 |