Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $236.45 / $258.91 / $1,728.23	Facility	54	$236.45	$258.91	$1,728.23
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,134.90 / $1,265.66 / $1,265.66	Facility	54	$1,134.90	$1,265.66	$1,265.66
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $413.00 / $413.00 / $713.06	Facility	54	$413.00	$413.00	$713.06