Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $100.00 / $100.00	Facility		$75.00	$100.00	$100.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $41.25 / $80.54 / $232.75	Facility		$41.25	$80.54	$232.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $16.59 / $16.59 / $16.59	Facility		$16.59	$16.59	$16.59