| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $93,754.74 | $93,754.74 | $93,754.74 | |
HMSA
| Facility | $79,799.00 | $93,243.00 | $108,580.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |