| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $879.39 | $879.39 | $879.39 |
Martin's Point
| Facility | QX | $879.39 | $879.39 | $879.39 |
Anesthesia Biceps Tenodesis Rupture Long Tendon
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $879.39 | $879.39 | $879.39 |
Martin's Point
| Facility | QX | $879.39 | $879.39 | $879.39 |