| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $35,481.96 | $35,481.96 | $35,481.96 | |
HMSA
| Facility | $19,025.00 | $22,230.00 | $25,886.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |