| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,449.80 | $4,449.80 | $5,562.25 |
New Technology - Level 29 ($5501-$6000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $4,449.80 | $4,449.80 | $5,562.25 |