| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medical Mutual of Ohio
| Facility | $8.51 | $8.51 | $8.51 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medical Mutual of Ohio
| Facility | $8.51 | $8.51 | $8.51 |