Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,137.96 / $4,466.84	Facility		$1,659.59	$2,137.96	$4,466.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20