| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $248.00 | $248.00 | $248.00 |
Wellcare
| Facility | QK | $37.00 | $37.00 | $39.50 |
Wellcare
| Facility | QX | $37.00 | $37.00 | $39.50 |
Anesthesia Tenoplasty Elbow To Shoulder
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $248.00 | $248.00 | $248.00 |
Wellcare
| Facility | QK | $37.00 | $37.00 | $39.50 |
Wellcare
| Facility | QX | $37.00 | $37.00 | $39.50 |