Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $165.96 / $194.98	Facility		$100.00	$165.96	$194.98