| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,056.51 | $1,315.60 | $1,644.50 |
New Technology - Level 17 ($1501-$1600)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,056.51 | $1,315.60 | $1,644.50 |