Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $331.13 / $371.54	Facility		$275.42	$331.13	$371.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $239.88	Facility		$234.42	$234.42	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $380.19 / $489.78	Professional		$234.42	$380.19	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $245.47 / $457.09	Professional		$190.55	$245.47	$457.09