- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $18,011.50 / $19,037.30
| Facility | | $3,822.00 | $18,011.50 | $19,037.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $9,046.00 / $39,702.26
| Facility | | $3,400.00 | $9,046.00 | $39,702.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,286.54 / $17,009.03 / $25,700.84
| Facility | | $10,286.54 | $17,009.03 | $25,700.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,438.00 / $8,148.00 / $24,154.57
| Facility | | $4,438.00 | $8,148.00 | $24,154.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,820.90 / $17,135.06 / $26,460.56
| Facility | | $14,820.90 | $17,135.06 | $26,460.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $9,046.00 / $39,702.26
| Facility | | $3,400.00 | $9,046.00 | $39,702.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $8,344.00 / $19,560.09
| Facility | | $3,400.00 | $8,344.00 | $19,560.09 |