| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $21,883.93 | $21,883.93 | $21,883.93 | |
HMSA
| Facility | $10,298.00 | $12,032.00 | $14,012.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |