| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,428.79 | $2,428.79 | $2,654.43 |
New Technology - Level 6 ($401 - $500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,428.79 | $2,428.79 | $2,654.43 |