| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $83.18 | $83.18 | $83.18 |
Wellcare
| Facility | QK | $52.48 | $52.48 | $52.48 |
Wellcare
| Facility | QX | $52.48 | $52.48 | $52.48 |
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 | $83.18 | $83.18 | $83.18 |
Wellcare
| Facility | QK | $52.48 | $52.48 | $52.48 |
Wellcare
| Facility | QX | $52.48 | $52.48 | $52.48 |