Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $104.71 / $114.82	Facility		$81.28	$104.71	$114.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20