| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $670.80 | $670.80 | $670.80 |
Aetna
| Facility | QZ | $2,518.06 | $3,155.49 | $4,000.55 |
Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $670.80 | $670.80 | $670.80 |
Aetna
| Facility | QZ | $2,518.06 | $3,155.49 | $4,000.55 |