| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $202,423.02 | $202,423.02 | $202,423.02 | |
HMSA
| Facility | $102,954.55 | $122,099.00 | $142,182.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |