- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $5,100.00 / $14,204.40
| Facility | | $789.00 | $5,100.00 | $14,204.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,033.02 / $14,156.98 / $21,911.23
| Facility | | $10,033.02 | $14,156.98 | $21,911.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $11,354.82 / $17,528.88
| Facility | | $2,089.36 | $11,354.82 | $17,528.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,365.34 / $14,257.48 / $19,306.00
| Facility | | $9,365.34 | $14,257.48 | $19,306.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,185.85 / $15,432.25 / $22,640.15
| Facility | | $10,185.85 | $15,432.25 | $22,640.15 |