| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $398.11 | $398.11 | $398.11 |
Martin's Point
| Facility | QX | $398.11 | $398.11 | $398.11 |
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $398.11 | $398.11 | $398.11 |
Martin's Point
| Facility | QX | $398.11 | $398.11 | $398.11 |