| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $34,174.36 | $34,174.36 | $34,174.36 | |
HMSA
| Facility | $10,386.00 | $12,136.00 | $14,132.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |