| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,862.09 | $2,570.40 | $3,311.31 | |
Providence
| Facility | $1,862.09 | $2,570.40 | $4,365.16 |
New Technology - Level 21 ($1901-$2000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,862.09 | $2,570.40 | $3,311.31 | |
Providence
| Facility | $1,862.09 | $2,570.40 | $4,365.16 |