| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $125.93 | $165.10 | $176.12 | |
United
| Professional | $85.00 | $85.00 | $85.00 |
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 | $125.93 | $165.10 | $176.12 | |
United
| Professional | $85.00 | $85.00 | $85.00 |