| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $37,390.64 | $37,390.64 | $37,390.64 | |
HMSA
| Facility | $59,495.00 | $69,518.00 | $80,953.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |