| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | QK | $162.80 | $162.80 | $162.80 |
Providence
| Facility | QX | $162.80 | $162.80 | $162.80 |
Providence
| Facility | QY | $162.80 | $162.80 | $162.80 |
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | QK | $162.80 | $162.80 | $162.80 |
Providence
| Facility | QX | $162.80 | $162.80 | $162.80 |
Providence
| Facility | QY | $162.80 | $162.80 | $162.80 |