- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $16,539.09 / $17,481.00
| Facility | | $3,137.00 | $16,539.09 | $17,481.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $9,046.00 / $34,094.93
| Facility | | $3,400.00 | $9,046.00 | $34,094.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,445.64 / $15,618.57 / $23,599.85
| Facility | | $9,445.64 | $15,618.57 | $23,599.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,438.00 / $8,148.00 / $24,208.00
| Facility | | $4,438.00 | $8,148.00 | $24,208.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,609.32 / $15,734.30 / $24,297.46
| Facility | | $13,609.32 | $15,734.30 | $24,297.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $9,046.00 / $34,094.93
| Facility | | $3,400.00 | $9,046.00 | $34,094.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $8,344.00 / $17,961.09
| Facility | | $3,400.00 | $8,344.00 | $17,961.09 |