Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $99.53 / $174.82 / $290.92	Facility		$99.53	$174.82	$290.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $205.97 / $654.89 / $666.28	Facility		$205.97	$654.89	$666.28