Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Professional		$380.19	$380.19	$380.19
Medcost Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $190.55 / $346.74	Facility		$87.10	$190.55	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20