| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $119,864.65 | $119,864.65 | $119,864.65 | |
HMSA
| Facility | $74,031.00 | $86,503.00 | $100,731.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |