- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $6,085.00 / $14,346.60
| Facility | | $789.00 | $6,085.00 | $14,346.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,775.01 / $10,775.01 / $20,684.48
| Facility | | $10,775.01 | $10,775.01 | $20,684.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $11,862.94 / $18,392.53
| Facility | | $2,200.00 | $11,862.94 | $18,392.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,728.20 / $14,669.50 / $19,836.41
| Facility | | $9,728.20 | $14,669.50 | $19,836.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,821.14 / $16,286.86 / $23,517.33
| Facility | | $10,821.14 | $16,286.86 | $23,517.33 |