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
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility		$1,258.93	$1,258.93	$1,258.93
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 / $1,230.27 / $2,187.76	Facility		$1,023.29	$1,230.27	$2,187.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Facility		$3,801.89	$3,801.89	$3,801.89
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 $1,621.81 / $19,952.62 / $63,095.73	Facility		$1,621.81	$19,952.62	$63,095.73