Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $107.04 / $143.85 / $157.62	Facility		$107.04	$143.85	$157.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $80.00 / $80.00	Professional		$75.00	$80.00	$80.00