| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,594.00 | $3,594.00 | $3,594.00 | |
Cigna
| Facility | $23,797.88 | $23,797.88 | $23,797.88 | |
HMSA
| Facility | $47,891.00 | $55,959.00 | $65,163.00 | |
United
| Facility | $3,775.00 | $3,775.00 | $3,775.00 |