| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $1,250.59 | $1,250.59 | $1,250.59 |
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 | QX | $1,250.59 | $1,250.59 | $1,250.59 |