| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $1,598.85 | $1,598.85 | $1,598.85 |
Aetna
| Facility | QX | $2,633.40 | $2,633.40 | $2,633.40 |
Anes Facial Bones/Skull Rad Surg W/Prognathism
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $1,598.85 | $1,598.85 | $1,598.85 |
Aetna
| Facility | QX | $2,633.40 | $2,633.40 | $2,633.40 |