Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $141.25 / $416.87	Professional		$93.33	$141.25	$416.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $158.49 / $169.82	Facility		$95.50	$158.49	$169.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $223.87	Professional		$91.20	$114.82	$223.87
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $190.55	Professional		$123.03	$123.03	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $416.87 / $691.83	Professional		$323.59	$416.87	$691.83