| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,235.94 | $4,073.80 | $5,754.40 |
New Technology - Level 25 ($3501-$4000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,235.94 | $4,073.80 | $5,754.40 |
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