Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $14.13	Professional		$14.13	$14.13	$14.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $17.38 / $20.42	Professional		$14.13	$17.38	$20.42
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $15.85 / $16.98	Professional		$15.85	$15.85	$16.98