Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
CareSource Facility/Professional Facility Modifier Low / Median / High Price $115.26 / $115.26 / $115.26	Facility		$115.26	$115.26	$115.26
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $78.41 / $78.41 / $78.41	Facility		$78.41	$78.41	$78.41
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $78.41 / $80.59 / $102.56	Professional		$78.41	$80.59	$102.56