Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $91.20 / $100.00	Facility		$72.44	$91.20	$100.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $213.80 / $19,054.61	Facility		$141.25	$213.80	$19,054.61
Optum Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,096.48	Facility		$1,023.29	$1,023.29	$1,096.48
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $4,365.16 / $4,365.16	Facility		$4,365.16	$4,365.16	$4,365.16
United Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $21,877.62 / $63,095.73	Facility		$5,011.87	$21,877.62	$63,095.73