| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | QK | $39.50 | $39.50 | $39.50 |
Medica
| Facility | QX | $39.50 | $39.50 | $39.50 |
Anesthesia Tenoplasty Elbow To Shoulder
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | QK | $39.50 | $39.50 | $39.50 |
Medica
| Facility | QX | $39.50 | $39.50 | $39.50 |