| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $37,021.56 | $37,021.56 | $37,021.56 | |
HMSA
| Facility | $25,794.00 | $30,139.00 | $35,097.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |