| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $40,253.66 | $40,253.66 | $40,253.66 | |
HMSA
| Facility | $19,877.00 | $23,226.00 | $27,046.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |