| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,733.90 | $5,346.19 | $6,808.96 |
New Technology - Level 26 ($4001-$4500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,733.90 | $5,346.19 | $6,808.96 |
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