| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,096.48 | $2,951.21 | $4,570.88 |
New Technology - Level 23 ($2501-$3000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,096.48 | $2,951.21 | $4,570.88 |
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