| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $55,127.67 | $55,127.67 | $55,127.67 | |
HMSA
| Facility | $36,690.00 | $42,871.00 | $49,923.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |