- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $11,051.70 / $25,333.00
| Facility | | $2,318.00 | $11,051.70 | $25,333.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,029.31 / $19,029.31 / $19,029.31
| Facility | | $19,029.31 | $19,029.31 | $19,029.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,987.77 / $17,667.57 / $28,064.14
| Facility | | $10,987.77 | $17,667.57 | $28,064.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,886.70 / $17,253.77 / $30,697.20
| Facility | | $10,886.70 | $17,253.77 | $30,697.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $12,715.92 / $36,299.49
| Facility | | $2,800.00 | $12,715.92 | $36,299.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $9,420.00 / $24,678.17
| Facility | | $2,800.00 | $9,420.00 | $24,678.17 |