- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $5,100.00 / $14,866.60
| Facility | | $789.00 | $5,100.00 | $14,866.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,676.43 / $13,347.91 / $19,479.00
| Facility | | $10,676.43 | $13,347.91 | $19,479.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $11,742.72 / $18,346.04
| Facility | | $2,089.36 | $11,742.72 | $18,346.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,801.93 / $14,902.73 / $19,986.75
| Facility | | $9,801.93 | $14,902.73 | $19,986.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,660.69 / $16,151.67 / $23,695.58
| Facility | | $10,660.69 | $16,151.67 | $23,695.58 |