| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $5,124.45 | $5,124.45 | $5,600.50 |
New Technology - Level 11 ($901 - $1000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $5,124.45 | $5,124.45 | $5,600.50 |