Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $691.83 / $1,318.26	Facility		$537.03	$691.83	$1,318.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20