- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $6,085.00 / $10,640.40
| Facility | | $970.00 | $6,085.00 | $10,640.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,612.82 / $11,136.02 / $14,965.88
| Facility | | $7,612.82 | $11,136.02 | $14,965.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $8,591.87 / $13,816.27
| Facility | | $2,089.36 | $8,591.87 | $13,816.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,015.52 / $10,680.19 / $14,973.00
| Facility | | $7,015.52 | $10,680.19 | $14,973.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,284.51 / $11,560.20 / $17,918.00
| Facility | | $7,284.51 | $11,560.20 | $17,918.00 |