| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $944.64 | $944.64 | $1,086.33 |
New Technology - Level 11 ($901 - $1000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $944.64 | $944.64 | $1,086.33 |