| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $1,121.00 | $2,786.00 | $3,264.00 | |
Medical Mutual of Ohio
| Professional | $388.77 | $397.82 | $397.82 |
Plmt Xtn Prosth Evasc Rpr Arysm/Dsj Ea Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $1,121.00 | $2,786.00 | $3,264.00 | |
Medical Mutual of Ohio
| Professional | $388.77 | $397.82 | $397.82 |