Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QK	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QX	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QY	$203.50	$203.50	$203.50
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $145.00 / $156.25 / $203.50	Professional	QX	$145.00	$156.25	$203.50
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $145.00 / $156.25 / $203.50	Professional	QY	$145.00	$156.25	$203.50
Regence BlueShield Facility/Professional Professional Modifier QX Low / Median / High Price $144.38 / $172.50 / $208.55	Professional	QX	$144.38	$172.50	$208.55
Regence BlueShield Facility/Professional Professional Modifier QY Low / Median / High Price $144.38 / $172.50 / $208.55	Professional	QY	$144.38	$172.50	$208.55