- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,058.00 / $8,419.06 / $15,448.00
| Facility | | $2,058.00 | $8,419.06 | $15,448.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,443.95 / $10,455.36 / $20,077.00
| Facility | | $9,443.95 | $10,455.36 | $20,077.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,691.96 / $11,207.53
| Facility | | $1,474.01 | $5,691.96 | $11,207.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,355.00 / $11,014.70 / $17,062.25
| Facility | | $4,355.00 | $11,014.70 | $17,062.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,385.00 / $9,855.76 / $27,165.85
| Facility | | $5,385.00 | $9,855.76 | $27,165.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,769.00 / $9,486.00 / $15,534.56
| Facility | | $4,769.00 | $9,486.00 | $15,534.56 |