| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $741.31 | $933.25 | $1,318.26 |
New Technology - Level 10 ($801 - $900)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $741.31 | $933.25 | $1,318.26 |
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