Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $178.56 / $325.83 / $801.25	Facility		$178.56	$325.83	$801.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,705.82 / $2,772.41 / $2,980.24	Facility		$2,705.82	$2,772.41	$2,980.24