| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $41,289.73 | $41,289.73 | $41,289.73 | |
HMSA
| Facility | $26,211.00 | $30,626.00 | $35,664.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |