| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $25,603.75 | $25,603.75 | $25,603.75 | |
HMSA
| Facility | $14,789.00 | $17,281.00 | $20,123.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |