| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $22,664.27 | $22,664.27 | $22,664.27 | |
HMSA
| Facility | $21,974.00 | $25,676.00 | $29,899.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |