| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,099.43 | $5,574.76 | $7,197.85 | |
Providence
| Facility | $4,099.43 | $5,574.76 | $9,819.59 |
New Technology - Level 26 ($4001-$4500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,099.43 | $5,574.76 | $7,197.85 | |
Providence
| Facility | $4,099.43 | $5,574.76 | $9,819.59 |