| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $28,851.67 | $28,851.67 | $28,851.67 | |
HMSA
| Facility | $20,874.00 | $24,391.00 | $28,403.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |