| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $42,776.60 | $42,776.60 | $42,776.60 | |
HMSA
| Facility | $44,985.00 | $52,564.00 | $61,210.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |