Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $140.47 / $456.62 / $728.92	Facility		$140.47	$456.62	$728.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $76.16 / $350.20 / $907.12	Facility		$76.16	$350.20	$907.12