| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aultcare
| Facility | $0.99 | $0.99 | $0.99 | |
CareSource
| Facility | $3.26 | $55,999.44 | $59,702.01 | |
CareSource
| Professional | $3.26 | $3.26 | $3.26 | |
Medical Mutual of Ohio
| Facility | $5.81 | $10.13 | $23.28 | |
Medical Mutual of Ohio
| Professional | $1.21 | $1.21 | $1.21 |