| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,258.93 | $1,584.89 | $2,238.72 |
New Technology - Level 16 ($1401 - $1500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,258.93 | $1,584.89 | $2,238.72 |
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