| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,737.80 | $2,290.87 | $4,466.84 |
New Technology - Level 21 ($1901-$2000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,737.80 | $2,290.87 | $4,466.84 |
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