| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $15,135.61 | $19,054.61 | $26,915.35 |
New Technology - Level 39 ($15,001-$20,000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $15,135.61 | $19,054.61 | $26,915.35 |
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