| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $940.32 | $1,059.81 | $1,267.59 |
New Technology - Level 13 ($1101 - $1200)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $940.32 | $1,059.81 | $1,267.59 |
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