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 $794.33 / $1,047.13 / $1,122.02	Facility		$794.33	$1,047.13	$1,122.02