| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,555.60 | $3,182.31 | $3,977.88 |
New Technology - Level 25 ($3501-$4000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,555.60 | $3,182.31 | $3,977.88 |