| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,881.18 | $2,558.19 | $3,303.00 | |
Providence
| Facility | $1,881.18 | $2,558.19 | $4,506.09 |
New Technology - Level 21 ($1901-$2000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,881.18 | $2,558.19 | $3,303.00 | |
Providence
| Facility | $1,881.18 | $2,558.19 | $4,506.09 |