| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,553.76 | $4,553.76 | $4,553.76 | |
Medical Mutual of Ohio
| Facility | $4,553.76 | $4,553.76 | $4,553.76 |
New Technology - Level 20 ($1801-$1900)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,553.76 | $4,553.76 | $4,553.76 | |
Medical Mutual of Ohio
| Facility | $4,553.76 | $4,553.76 | $4,553.76 |