| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medical Mutual of Ohio
| Facility | $0.08 | $0.35 | $13.94 | |
United
| Facility | $5,069.00 | $5,069.00 | $5,069.00 |
Pharmacy - Drugs Incident to Radiology
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medical Mutual of Ohio
| Facility | $0.08 | $0.35 | $13.94 | |
United
| Facility | $5,069.00 | $5,069.00 | $5,069.00 |