| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $707.95 | $3,090.30 | $4,073.80 | |
Medical Mutual of Ohio
| Professional | $309.03 | $309.03 | $323.59 | |
Molina
| Professional | $39.81 | $50.12 | $60.26 |
Intro Guide Pelvis&/Ureter W/Dilat Nfros Tract
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $707.95 | $3,090.30 | $4,073.80 | |
Medical Mutual of Ohio
| Professional | $309.03 | $309.03 | $323.59 | |
Molina
| Professional | $39.81 | $50.12 | $60.26 |