Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $1,500.00	Professional		$60.00	$60.00	$1,500.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.50 / $162.50 / $162.50	Facility		$162.50	$162.50	$162.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $195.00 / $203.13 / $284.38	Professional		$195.00	$203.13	$284.38
United Facility/Professional Professional Modifier Low / Median / High Price $199.56 / $199.56 / $199.56	Professional		$199.56	$199.56	$199.56