- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $6,085.00 / $13,524.60
| Facility | | $970.00 | $6,085.00 | $13,524.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,904.44 / $15,080.65 / $17,269.18
| Facility | | $7,904.44 | $15,080.65 | $17,269.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $10,873.87 / $16,859.05
| Facility | | $2,089.36 | $10,873.87 | $16,859.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,917.11 / $13,575.11 / $18,382.00
| Facility | | $8,917.11 | $13,575.11 | $18,382.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,259.01 / $14,693.65 / $23,021.00
| Facility | | $9,259.01 | $14,693.65 | $23,021.00 |