Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $499.21 / $499.21 / $499.21	Facility		$499.21	$499.21	$499.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.37 / $320.92 / $320.92	Professional		$128.37	$320.92	$320.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $499.21 / $499.21 / $499.21	Facility		$499.21	$499.21	$499.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $392.23 / $392.23 / $392.23	Professional		$392.23	$392.23	$392.23