| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,289.09 | $3,289.09 | $4,111.35 |
New Technology - Level 26 ($4001-$4500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,289.09 | $3,289.09 | $4,111.35 |