| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $12,423.54 | $12,423.54 | $14,287.07 |
New Technology - Level 38 ($10,001-$15,000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $12,423.54 | $12,423.54 | $14,287.07 |