| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $40,464.57 | $40,464.57 | $40,464.57 | |
HMSA
| Facility | $14,793.00 | $17,285.00 | $20,128.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |