| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,237.00 | $4,030.80 | $5,038.50 |
New Technology - Level 27 ($4501-$5000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,237.00 | $4,030.80 | $5,038.50 |