| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $54,819.22 | $54,819.22 | $54,819.22 | |
HMSA
| Facility | $19,253.00 | $22,496.00 | $26,197.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |