| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $24,161.69 | $24,161.69 | $24,161.69 | |
HMSA
| Facility | $12,309.00 | $14,383.00 | $16,748.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |