| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $21,285.49 | $21,285.49 | $21,285.49 | |
HMSA
| Facility | $11,213.00 | $13,102.00 | $15,258.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |