| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $41,503.26 | $41,503.26 | $41,503.26 | |
HMSA
| Facility | $22,143.00 | $25,873.00 | $30,129.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |