| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | QK | $244.20 | $244.20 | $244.20 |
Providence
| Facility | QX | $244.20 | $244.20 | $244.20 |
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | QK | $244.20 | $244.20 | $244.20 |
Providence
| Facility | QX | $244.20 | $244.20 | $244.20 |