| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $21,103.58 | $21,103.58 | $21,103.58 | |
HMSA
| Facility | $11,360.00 | $13,274.00 | $15,457.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |