Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $215.25 / $258.83 / $413.55	Facility	54	$215.25	$258.83	$413.55
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $413.00 / $413.00 / $413.00	Facility	54	$413.00	$413.00	$413.00
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