Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $588.04 / $1,023.00 / $1,329.90	Professional		$588.04	$1,023.00	$1,329.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $303.42 / $811.25 / $1,163.33	Professional		$303.42	$811.25	$1,163.33