| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $54,323.60 | $54,323.60 | $54,323.60 | |
HMSA
| Facility | $37,904.00 | $44,290.00 | $51,575.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |