| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $43,775.76 | $43,775.76 | $43,775.76 | |
HMSA
| Facility | $28,006.00 | $32,725.00 | $38,107.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |