Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $100.00 / $100.00	Facility		$87.10	$100.00	$100.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $194.98 / $316.23	Facility		$117.49	$194.98	$316.23
Optum Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $812.83	Facility		$691.83	$691.83	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $812.83	Facility		$691.83	$691.83	$812.83