Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $274.85 / $274.85 / $274.85	Facility		$274.85	$274.85	$274.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $76.16 / $350.20 / $907.12	Facility		$76.16	$350.20	$907.12