| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $14,921.46 | $14,921.46 | $14,921.46 | |
HMSA
| Facility | $23,694.00 | $27,686.00 | $32,239.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |