| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,615.46 | $1,824.41 | $2,323.59 |
New Technology - Level 16 ($1401 - $1500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,615.46 | $1,824.41 | $2,323.59 |
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