| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $52,733.91 | $52,733.91 | $52,733.91 | |
HMSA
| Facility | $25,724.00 | $30,058.00 | $35,002.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |