| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,022.05 | $1,151.92 | $1,377.76 |
New Technology - Level 14 ($1201- $1300)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,022.05 | $1,151.92 | $1,377.76 |
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