| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $899.00 | $899.00 | $899.00 |
Medica
| Facility | QK | $39.50 | $39.50 | $39.50 |
Medica
| Facility | QX | $39.50 | $39.50 | $39.50 |
Medica
| Facility | QY | $39.50 | $39.50 | $39.50 |
Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $899.00 | $899.00 | $899.00 |
Medica
| Facility | QK | $39.50 | $39.50 | $39.50 |
Medica
| Facility | QX | $39.50 | $39.50 | $39.50 |
Medica
| Facility | QY | $39.50 | $39.50 | $39.50 |