- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $6,085.00 / $12,493.00
| Facility | | $970.00 | $6,085.00 | $12,493.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,332.48 / $10,337.03 / $19,971.65
| Facility | | $7,332.48 | $10,337.03 | $19,971.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $10,087.82 / $15,642.00
| Facility | | $2,089.36 | $10,087.82 | $15,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,237.00 / $12,539.73 / $17,153.20
| Facility | | $8,237.00 | $12,539.73 | $17,153.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,552.83 / $13,168.84 / $20,591.65
| Facility | | $8,552.83 | $13,168.84 | $20,591.65 |