- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $6,329.00 / $15,032.00
| Facility | | $1,965.00 | $6,329.00 | $15,032.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,743.20 / $6,508.67 / $11,404.89
| Facility | | $1,743.20 | $6,508.67 | $11,404.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,746.00 / $16,746.00 / $22,327.00
| Facility | | $16,746.00 | $16,746.00 | $22,327.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,709.52 / $2,154.50 / $7,167.00
| Facility | | $1,709.52 | $2,154.50 | $7,167.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,472.00 / $7,088.00 / $11,396.00
| Facility | | $1,472.00 | $7,088.00 | $11,396.00 |