| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,466.84 | $4,466.84 | $5,623.41 |
New Technology - Level 29 ($5501-$6000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,466.84 | $4,466.84 | $5,623.41 |