| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $36,895.01 | $36,895.01 | $36,895.01 | |
HMSA
| Facility | $48,271.00 | $56,403.00 | $65,680.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |