| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,934.00 | $4,934.00 | $4,934.00 | |
Cigna
| Facility | $25,232.03 | $25,232.03 | $25,232.03 | |
HMSA
| Facility | $12,788.00 | $14,269.00 | $16,616.00 | |
United
| Facility | $3,775.00 | $3,800.00 | $4,899.00 |