Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $199.78 / $245.48 / $385.61	Facility	54	$199.78	$245.48	$385.61
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $385.46 / $385.46 / $385.46	Facility	54	$385.46	$385.46	$385.46
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,057.56 / $1,176.15 / $1,176.15	Facility	54	$1,057.56	$1,176.15	$1,176.15
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $385.46 / $385.46 / $676.45	Facility	54	$385.46	$385.46	$676.45