Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $50.12	Professional		$30.20	$30.20	$50.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3.55 / $3.55 / $4.37	Professional		$3.55	$3.55	$4.37