Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $190.55	Facility		$114.82	$114.82	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $151.36	Professional		$138.04	$138.04	$151.36