| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,267.25 | $1,428.27 | $1,708.29 |
New Technology - Level 17 ($1501-$1600)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,267.25 | $1,428.27 | $1,708.29 |
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