| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,398.95 | $1,902.41 | $2,456.30 | |
Providence
| Facility | $1,398.95 | $1,902.41 | $3,350.98 |
New Technology - Level 16 ($1401 - $1500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,398.95 | $1,902.41 | $2,456.30 | |
Providence
| Facility | $1,398.95 | $1,902.41 | $3,350.98 |