Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
CareSource Facility/Professional Facility Modifier Low / Median / High Price $129.11 / $129.11 / $129.11	Facility		$129.11	$129.11	$129.11
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $87.83 / $87.83 / $87.83	Facility		$87.83	$87.83	$87.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $87.83 / $87.83 / $116.56	Professional		$87.83	$87.83	$116.56