| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $43,065.81 | $43,065.81 | $43,065.81 | |
Medical Mutual of Ohio
| Facility | $43,065.81 | $43,065.81 | $43,065.81 |
New Technology - Level 39 ($15,001-$20,000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $43,065.81 | $43,065.81 | $43,065.81 | |
Medical Mutual of Ohio
| Facility | $43,065.81 | $43,065.81 | $43,065.81 |