Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,290.00 / $1,290.00 / $1,290.00	Facility		$1,290.00	$1,290.00	$1,290.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,290.00 / $1,290.00 / $1,290.00	Facility		$1,290.00	$1,290.00	$1,290.00