| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $48,270.65 | $48,270.65 | $48,270.65 | |
HMSA
| Facility | $16,990.00 | $19,852.00 | $23,117.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |