- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,650.00 / $8,642.00 / $20,264.00
| Facility | | $1,650.00 | $8,642.00 | $20,264.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,463.00 / $11,874.02 / $21,973.14
| Facility | | $7,463.00 | $11,874.02 | $21,973.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,785.65 / $15,596.07 / $27,673.00
| Facility | | $10,785.65 | $15,596.07 | $27,673.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,864.00 / $14,373.00 / $22,251.00
| Facility | | $7,864.00 | $14,373.00 | $22,251.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,457.00 / $9,477.00 / $27,489.75
| Facility | | $4,457.00 | $9,477.00 | $27,489.75 |