| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,836.71 | $4,836.71 | $6,045.88 |
New Technology - Level 30 ($6001-$6500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,836.71 | $4,836.71 | $6,045.88 |