- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,600.00 / $10,290.90 / $18,390.00
| Facility | | $3,600.00 | $10,290.90 | $18,390.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,865.33 / $16,123.40 / $20,907.09
| Facility | | $10,865.33 | $16,123.40 | $20,907.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,798.17 / $15,226.33 / $21,829.91
| Facility | | $10,798.17 | $15,226.33 | $21,829.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,654.54 / $14,708.39 / $30,843.95
| Facility | | $7,654.54 | $14,708.39 | $30,843.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,798.17 / $16,449.39 / $21,835.30
| Facility | | $10,798.17 | $16,449.39 | $21,835.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,346.00 / $13,879.51 / $19,351.00
| Facility | | $4,346.00 | $13,879.51 | $19,351.00 |