Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $251.04 / $377.05	Facility		$250.00	$251.04	$377.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $202.62 / $211.43 / $246.67	Facility		$202.62	$211.43	$246.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $193.81 / $193.81 / $246.67	Professional		$193.81	$193.81	$246.67
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $352.38 / $520.10 / $630.76	Facility		$352.38	$520.10	$630.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $281.58 / $296.39 / $554.22	Professional		$281.58	$296.39	$554.22