| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,170.52 | $2,951.65 | $3,811.03 | |
Providence
| Facility | $2,170.52 | $2,951.65 | $5,199.14 |
New Technology - Level 22 ($2001-$2500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,170.52 | $2,951.65 | $3,811.03 | |
Providence
| Facility | $2,170.52 | $2,951.65 | $5,199.14 |