| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,000.00 | $1,258.93 | $1,778.28 |
New Technology - Level 13 ($1101 - $1200)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,000.00 | $1,258.93 | $1,778.28 |
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