| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,045.03 | $1,045.03 | $1,306.29 |
New Technology - Level 15 ($1301 - $1400)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,045.03 | $1,045.03 | $1,306.29 |