| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $561.00 | $561.00 | $999.80 |
Aetna
| Facility | QX | $823.36 | $823.36 | $924.00 |
Anes Arthrs Humeral H/N Strnclav & Shoulder Nos
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $561.00 | $561.00 | $999.80 |
Aetna
| Facility | QX | $823.36 | $823.36 | $924.00 |