| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $8,294.20 | $8,580.21 | $8,580.21 |
New Technology - Level 26 ($4001-$4500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $8,294.20 | $8,580.21 | $8,580.21 |