Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $105.48 / $146.33 / $280.89	Facility		$105.48	$146.33	$280.89
Qualchoice Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $162.60 / $401.22	Facility		$112.45	$162.60	$401.22