| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $58,515.31 | $58,515.31 | $58,515.31 | |
HMSA
| Facility | $30,756.00 | $35,938.00 | $41,849.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |