| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | QK | $39.81 | $39.81 | $39.81 |
Medica
| Facility | QX | $39.81 | $39.81 | $39.81 |
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | QK | $39.81 | $39.81 | $39.81 |
Medica
| Facility | QX | $39.81 | $39.81 | $39.81 |