Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,513.56 / $1,513.56	Facility		$1,230.27	$1,513.56	$1,513.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $1,047.13	Facility		$977.24	$977.24	$1,047.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,659.59 / $2,238.72	Professional		$1,047.13	$1,659.59	$2,238.72