Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Professional		$229.09	$229.09	$229.09
Medcost Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $169.82 / $295.12	Facility		$79.43	$169.82	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20