| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $27,876.24 | $27,876.24 | $27,876.24 | |
HMSA
| Facility | $11,643.00 | $13,604.00 | $15,842.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |