| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $870.96 | $870.96 | $870.96 |
Martin's Point
| Facility | QX | $870.96 | $870.96 | $870.96 |
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 |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $870.96 | $870.96 | $870.96 |
Martin's Point
| Facility | QX | $870.96 | $870.96 | $870.96 |