| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | QK | $39.81 | $39.81 | $39.81 |
Medica
| Facility | QX | $39.81 | $39.81 | $39.81 |
Medica
| Facility | QY | $39.81 | $39.81 | $39.81 |
Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | QK | $39.81 | $39.81 | $39.81 |
Medica
| Facility | QX | $39.81 | $39.81 | $39.81 |
Medica
| Facility | QY | $39.81 | $39.81 | $39.81 |