| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $872.20 | $872.20 | $872.20 |
Anes Nerve Musc Tendon Fascia & Bursae Upper Leg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $872.20 | $872.20 | $872.20 |