| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,621.81 | $1,621.81 | $1,905.46 |
New Technology - Level 18 ($1601-$1700)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,621.81 | $1,621.81 | $1,905.46 |