- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,862.00 / $7,629.00 / $14,026.13
| Facility | | $2,862.00 | $7,629.00 | $14,026.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,192.00 / $16,524.00 / $24,210.13
| Facility | | $10,192.00 | $16,524.00 | $24,210.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,212.00 / $9,619.46 / $15,639.00
| Facility | | $2,212.00 | $9,619.46 | $15,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,056.56 / $12,761.00 / $13,021.00
| Facility | | $10,056.56 | $12,761.00 | $13,021.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,943.00 / $10,336.00 / $17,772.00
| Facility | | $6,943.00 | $10,336.00 | $17,772.00 |