Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $5,128.61	Professional		$2,691.53	$2,691.53	$5,128.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $3,019.95	Facility		$2,951.21	$2,951.21	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,041.74 / $3,715.35	Professional		$1,659.59	$2,041.74	$3,715.35