Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Facility Modifier Low / Median / High Price $119.27 / $528.90 / $2,066.98	Facility		$119.27	$528.90	$2,066.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00