| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $63,410.92 | $63,410.92 | $63,410.92 | |
HMSA
| Facility | $115,003.00 | $128,318.00 | $149,424.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |