Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $56.25 / $56.25 / $56.25	Facility		$56.25	$56.25	$56.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $12.62 / $218.42 / $2,172.11	Facility		$12.62	$218.42	$2,172.11