| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $16,548.06 | $16,548.06 | $16,548.06 | |
HMSA
| Facility | $4,340.00 | $5,071.00 | $5,906.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |