- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $6,085.00 / $11,111.30
| Facility | | $970.00 | $6,085.00 | $11,111.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,840.96 / $8,897.98 / $14,691.11
| Facility | | $7,840.96 | $8,897.98 | $14,691.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $8,972.10 / $14,427.70
| Facility | | $2,089.36 | $8,972.10 | $14,427.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,325.98 / $11,152.83 / $15,256.04
| Facility | | $7,325.98 | $11,152.83 | $15,256.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,837.18 / $11,712.36 / $17,710.12
| Facility | | $7,837.18 | $11,712.36 | $17,710.12 |