| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $1,598.85 | $1,598.85 | $1,598.85 |
Aetna
| Facility | QX | $2,633.40 | $2,633.40 | $2,633.40 |
Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $1,598.85 | $1,598.85 | $1,598.85 |
Aetna
| Facility | QX | $2,633.40 | $2,633.40 | $2,633.40 |