- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,497.00 / $10,344.70 / $17,313.30
| Facility | | $7,497.00 | $10,344.70 | $17,313.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,834.58 / $13,166.85 / $14,485.56
| Facility | | $12,834.58 | $13,166.85 | $14,485.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $11,722.10 / $17,944.00
| Facility | | $2,423.00 | $11,722.10 | $17,944.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,673.12 / $11,638.20 / $19,517.18
| Facility | | $7,673.12 | $11,638.20 | $19,517.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $9,392.67 / $20,885.68
| Facility | | $2,600.00 | $9,392.67 | $20,885.68 |