Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $891.25 / $1,698.24	Facility		$660.69	$891.25	$1,698.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20