| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $4.90 | $55,999.44 | $59,702.01 | |
CareSource
| Professional | $4.90 | $4.90 | $4.90 | |
Medical Mutual of Ohio
| Facility | $12.43 | $18.80 | $127.09 | |
Medical Mutual of Ohio
| Professional | $1.98 | $1.98 | $1.98 |