| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $52,675.91 | $52,675.91 | $52,675.91 | |
HMSA
| Facility | $127,995.00 | $149,559.00 | $174,159.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |