Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $229.09 / $257.04	Facility		$93.33	$229.09	$257.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $128.82	Professional		$87.10	$104.71	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $93.33 / $117.49	Professional		$81.28	$93.33	$117.49