| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,934.00 | $4,934.00 | $4,934.00 | |
Cigna
| Facility | $17,773.93 | $17,773.93 | $17,773.93 | |
HMSA
| Facility | $7,930.00 | $8,849.00 | $10,304.00 | |
United
| Facility | $3,775.00 | $3,800.00 | $4,899.00 |