Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,873.00 / $2,122.00 / $5,856.00	Facility		$1,873.00	$2,122.00	$5,856.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $135.00 / $224.00 / $575.00	Facility		$135.00	$224.00	$575.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,002.00 / $5,000.00 / $5,000.00	Facility		$4,002.00	$5,000.00	$5,000.00
Optum Facility/Professional Facility Modifier Low / Median / High Price $1,017.00 / $1,017.00 / $1,017.00	Facility		$1,017.00	$1,017.00	$1,017.00
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $1,017.00 / $1,017.00 / $1,017.00	Facility		$1,017.00	$1,017.00	$1,017.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,144.00 / $1,747.00 / $1,747.00	Facility		$1,144.00	$1,747.00	$1,747.00