| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $52,897.36 | $52,897.36 | $52,897.36 | |
HMSA
| Facility | $26,868.00 | $31,394.00 | $36,558.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |