Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Medcost Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $117.49 / $186.21	Facility		$85.11	$117.49	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20