| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $31,271.79 | $31,271.79 | $31,271.79 | |
HMSA
| Facility | $22,168.00 | $25,903.00 | $30,164.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |