Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $393.93 / $1,619.00	Professional		$393.93	$393.93	$1,619.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $493.33 / $823.59 / $823.59	Facility		$493.33	$823.59	$823.59
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,021.69 / $1,021.69 / $1,021.69	Professional		$1,021.69	$1,021.69	$1,021.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $216.00 / $227.00 / $227.00	Facility		$216.00	$227.00	$227.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $572.88 / $572.88 / $572.88	Professional		$572.88	$572.88	$572.88
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $120.00 / $144.00	Professional		$80.00	$120.00	$144.00