| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,392.71 | $1,572.85 | $2,003.20 |
New Technology - Level 14 ($1201- $1300)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,392.71 | $1,572.85 | $2,003.20 |
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