Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.18 / $77.52 / $131.10	Facility		$41.18	$77.52	$131.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $80.00 / $80.00	Professional		$75.00	$80.00	$80.00