| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $16,878.55 | $22,952.86 | $29,635.59 | |
Providence
| Facility | $16,878.55 | $22,952.86 | $40,430.01 |
New Technology - Level 39 ($15,001-$20,000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $16,878.55 | $22,952.86 | $29,635.59 | |
Providence
| Facility | $16,878.55 | $22,952.86 | $40,430.01 |