| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $50,856.86 | $50,856.86 | $50,856.86 | |
HMSA
| Facility | $20,251.00 | $23,663.00 | $27,555.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |