- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $8,240.00 / $14,725.30
| Facility | | $2,318.00 | $8,240.00 | $14,725.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,370.21 / $9,604.32 / $11,355.54
| Facility | | $9,370.21 | $9,604.32 | $11,355.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,261.67 / $10,131.96 / $16,257.63
| Facility | | $6,261.67 | $10,131.96 | $16,257.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,328.08 / $10,029.04 / $17,843.27
| Facility | | $6,328.08 | $10,029.04 | $17,843.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $8,485.37 / $21,099.70
| Facility | | $2,800.00 | $8,485.37 | $21,099.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $8,291.00 / $17,693.70
| Facility | | $2,800.00 | $8,291.00 | $17,693.70 |