| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $18,907.54 | $18,907.54 | $18,907.54 | |
HMSA
| Facility | $18,707.00 | $21,859.00 | $25,454.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |