- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $4,479.00 / $9,248.37
| Facility | | $789.00 | $4,479.00 | $9,248.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,092.62 / $8,092.62 / $10,025.64
| Facility | | $8,092.62 | $8,092.62 | $10,025.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $7,488.58 / $11,528.58
| Facility | | $2,089.36 | $7,488.58 | $11,528.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,097.71 / $9,282.95 / $12,570.00
| Facility | | $6,097.71 | $9,282.95 | $12,570.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,631.93 / $10,047.83 / $14,740.84
| Facility | | $6,631.93 | $10,047.83 | $14,740.84 |