Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $195.00 / $217.20 / $247.56	Professional	QX	$195.00	$217.20	$247.56
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $195.00 / $217.20 / $247.56	Professional	QY	$195.00	$217.20	$247.56