| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $776.86 | $875.57 | $1,047.22 |
New Technology - Level 11 ($901 - $1000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $776.86 | $875.57 | $1,047.22 |
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