| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,882.66 | $4,376.02 | $5,233.97 |
New Technology - Level 27 ($4501-$5000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,882.66 | $4,376.02 | $5,233.97 |
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