Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $99.05 / $99.05 / $99.05	Facility		$99.05	$99.05	$99.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.48 / $123.48 / $123.48	Facility		$123.48	$123.48	$123.48