| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $13,489.63 | $13,489.63 | $16,982.44 |
New Technology - Level 39 ($15,001-$20,000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $13,489.63 | $13,489.63 | $16,982.44 |