| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $26,829.63 | $26,829.63 | $26,829.63 | |
HMSA
| Facility | $14,564.00 | $17,018.00 | $19,817.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |