| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,691.53 | $2,691.53 | $2,884.03 |
New Technology - Level 23 ($2501-$3000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,691.53 | $2,691.53 | $2,884.03 |