| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $21,290.76 | $21,290.76 | $21,290.76 | |
HMSA
| Facility | $14,502.00 | $16,945.00 | $19,732.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |