| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,187.76 | $3,311.31 | $5,248.07 | |
Providence
| Facility | $2,187.76 | $2,951.21 | $5,128.61 |
New Technology - Level 22 ($2001-$2500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,187.76 | $3,311.31 | $5,248.07 | |
Providence
| Facility | $2,187.76 | $2,951.21 | $5,128.61 |