| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,108.59 | $1,108.59 | $1,108.59 | |
Medical Mutual of Ohio
| Facility | $1,108.59 | $1,108.59 | $1,108.59 |
New Technology - Level 6 ($401 - $500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,108.59 | $1,108.59 | $1,108.59 | |
Medical Mutual of Ohio
| Facility | $1,108.59 | $1,108.59 | $1,108.59 |