- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $4,479.00 / $11,573.30
| Facility | | $789.00 | $4,479.00 | $11,573.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,165.07 / $8,165.07 / $8,165.07
| Facility | | $8,165.07 | $8,165.07 | $8,165.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $9,305.08 / $14,426.77
| Facility | | $2,089.36 | $9,305.08 | $14,426.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,630.62 / $11,506.50 / $15,559.33
| Facility | | $7,630.62 | $11,506.50 | $15,559.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,163.08 / $12,199.40 / $18,446.57
| Facility | | $8,163.08 | $12,199.40 | $18,446.57 |