Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $223.87 / $275.42	Facility		$173.78	$223.87	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Professional		$45.71	$45.71	$45.71