| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $50,000.00 | $50,000.00 | $50,000.00 |
New Technology - Level 39 ($15,001-$20,000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $50,000.00 | $50,000.00 | $50,000.00 |