| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,606.00 | $4,606.00 | $4,606.00 | |
Cigna
| Facility | $77,615.31 | $77,615.31 | $77,615.31 | |
HMSA
| Facility | $126,929.00 | $148,313.00 | $172,708.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |