Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Medcost Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $691.83 / $1,412.54	Facility		$549.54	$691.83	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20