Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $130.00 / $144.80 / $165.04	Professional	QX	$130.00	$144.80	$165.04
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $130.00 / $144.80 / $165.04	Professional	QY	$130.00	$144.80	$165.04