Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $251.32 / $251.32 / $315.95	Facility		$251.32	$251.32	$315.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $158.00 / $158.00 / $158.00	Facility		$158.00	$158.00	$158.00