Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $302.73 / $331.80 / $2,197.04	Facility	54	$302.73	$331.80	$2,197.04
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,447.50 / $1,605.14 / $1,605.14	Facility	54	$1,447.50	$1,605.14	$1,605.14
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $528.79 / $528.79 / $930.84	Facility	54	$528.79	$528.79	$930.84