| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $25,764.56 | $25,764.56 | $25,764.56 | |
HMSA
| Facility | $15,600.00 | $18,228.00 | $21,227.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |