Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $116.58 / $159.50 / $194.30	Facility		$116.58	$159.50	$194.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $266.36 / $266.36 / $445.12	Professional		$266.36	$266.36	$445.12