| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $848.64 | $848.64 | $2,271.88 |
Aetna
| Facility | QX | $791.07 | $791.07 | $1,155.87 |
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $848.64 | $848.64 | $2,271.88 |
Aetna
| Facility | QX | $791.07 | $791.07 | $1,155.87 |
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