| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $23,626.52 | $23,626.52 | $23,626.52 | |
HMSA
| Facility | $12,406.00 | $14,497.00 | $16,881.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |