Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,087.85 / $1,709.00 / $2,029.75	Facility		$1,087.85	$1,709.00	$2,029.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00