| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $5,108.64 | $5,757.78 | $6,886.63 |
New Technology - Level 30 ($6001-$6500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $5,108.64 | $5,757.78 | $6,886.63 |
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