| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $32,149.68 | $32,149.68 | $32,149.68 | |
HMSA
| Facility | $116,081.00 | $135,638.00 | $157,948.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |