| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,934.00 | $4,934.00 | $4,934.00 | |
Cigna
| Facility | $28,250.59 | $28,250.59 | $28,250.59 | |
HMSA
| Facility | $10,870.00 | $12,128.00 | $14,123.00 | |
United
| Facility | $3,775.00 | $3,800.00 | $4,899.00 |