Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $169.18 / $225.55 / $248.57	Facility		$169.18	$225.55	$248.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $80.00 / $80.00	Professional		$75.00	$80.00	$80.00