| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | QK | $30.90 | $30.90 | $30.90 |
Providence
| Facility | QX | $30.90 | $30.90 | $30.90 |
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 |
|---|---|---|---|---|---|
Providence
| Facility | QK | $30.90 | $30.90 | $30.90 |
Providence
| Facility | QX | $30.90 | $30.90 | $30.90 |