Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $198.36 / $213.77 / $1,522.50	Facility	54	$198.36	$213.77	$1,522.50
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,051.20 / $1,170.09 / $1,170.09	Facility	54	$1,051.20	$1,170.09	$1,170.09
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $383.22 / $383.22 / $654.61	Facility	54	$383.22	$383.22	$654.61