| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $647.66 | $806.50 | $1,008.12 |
New Technology - Level 11 ($901 - $1000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $647.66 | $806.50 | $1,008.12 |