| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,721.25 | $4,721.25 | $5,429.44 |
New Technology - Level 27 ($4501-$5000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,721.25 | $4,721.25 | $5,429.44 |