| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $52,599.46 | $52,599.46 | $52,599.46 | |
HMSA
| Facility | $36,872.00 | $43,084.00 | $50,171.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |