Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Professional		$389.05	$389.05	$389.05
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 Professional Modifier Low / Median / High Price $120.23 / $194.98 / $323.59	Professional		$120.23	$194.98	$323.59