- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $6,047.00 / $8,562.26
| Facility | | $970.00 | $6,047.00 | $8,562.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,158.26 / $10,158.26 / $11,261.83
| Facility | | $10,158.26 | $10,158.26 | $11,261.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $6,745.08 / $10,816.47
| Facility | | $2,089.36 | $6,745.08 | $10,816.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,492.30 / $8,527.16 / $12,651.20
| Facility | | $5,492.30 | $8,527.16 | $12,651.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,702.89 / $8,667.56 / $13,277.31
| Facility | | $5,702.89 | $8,667.56 | $13,277.31 |