- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,415.00 / $9,717.09 / $18,390.00
| Facility | | $2,415.00 | $9,717.09 | $18,390.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,795.12 / $15,758.66 / $21,830.02
| Facility | | $10,795.12 | $15,758.66 | $21,830.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,204.98 / $14,648.00 / $20,630.70
| Facility | | $10,204.98 | $14,648.00 | $20,630.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,234.05 / $13,900.39 / $29,149.57
| Facility | | $7,234.05 | $13,900.39 | $29,149.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,942.81 / $5,942.81 / $5,942.81
| Facility | | $5,942.81 | $5,942.81 | $5,942.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,204.98 / $15,545.76 / $20,635.79
| Facility | | $10,204.98 | $15,545.76 | $20,635.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,346.00 / $13,117.05 / $18,881.75
| Facility | | $4,346.00 | $13,117.05 | $18,881.75 |