| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $858.59 | $967.69 | $1,157.41 |
New Technology - Level 12 ($1001 - $1100)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $858.59 | $967.69 | $1,157.41 |
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