| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,277.18 | $1,277.18 | $1,596.47 |
New Technology - Level 18 ($1601-$1700)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,277.18 | $1,277.18 | $1,596.47 |