Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $912.01 / $912.01	Facility		$741.31	$912.01	$912.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $630.96	Facility		$588.84	$588.84	$630.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $977.24 / $1,348.96	Professional		$630.96	$977.24	$1,348.96