| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aultcare
| Facility | $12.34 | $12.34 | $12.34 | |
CareSource
| Facility | $5.30 | $5.30 | $7.42 | |
CareSource
| Professional | $5.30 | $5.30 | $12.72 | |
Medical Mutual of Ohio
| Professional | $3.06 | $3.06 | $3.06 | |
Molina
| Professional | $10.13 | $11.51 | $13.35 |