| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $394.14 | $394.14 | $394.14 |
Martin's Point
| Facility | QX | $394.14 | $394.14 | $394.14 |
Anesthesia Open Tenotomy Elbow To Shoulder
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $394.14 | $394.14 | $394.14 |
Martin's Point
| Facility | QX | $394.14 | $394.14 | $394.14 |