Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Facility Modifier Low / Median / High Price $163.32 / $189.30 / $248.02	Facility		$163.32	$189.30	$248.02
Medcost Facility/Professional Professional Modifier Low / Median / High Price $128.91 / $128.91 / $128.91	Professional		$128.91	$128.91	$128.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00