Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $847.20 / $847.20 / $847.20	Facility		$847.20	$847.20	$847.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $158.00 / $158.00 / $158.00	Facility		$158.00	$158.00	$158.00