| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,389.47 | $4,389.47 | $5,918.09 |
New Technology - Level 14 ($1201- $1300)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,389.47 | $4,389.47 | $5,918.09 |