Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $180.48 / $180.48 / $180.48	Facility		$180.48	$180.48	$180.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $158.00 / $158.00 / $158.00	Facility		$158.00	$158.00	$158.00