Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.36 / $127.68 / $152.09	Facility		$38.36	$127.68	$152.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $80.00 / $80.00	Professional		$75.00	$80.00	$80.00