- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $11,762.40 / $12,300.00
| Facility | | $3,822.00 | $11,762.40 | $12,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $8,344.00 / $22,503.96
| Facility | | $3,400.00 | $8,344.00 | $22,503.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,646.15 / $10,989.55 / $16,605.34
| Facility | | $6,646.15 | $10,989.55 | $16,605.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,438.00 / $8,148.00 / $15,606.29
| Facility | | $4,438.00 | $8,148.00 | $15,606.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,575.79 / $11,070.98 / $17,096.20
| Facility | | $9,575.79 | $11,070.98 | $17,096.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $8,344.00 / $22,503.96
| Facility | | $3,400.00 | $8,344.00 | $22,503.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $7,638.02 / $11,358.00
| Facility | | $3,400.00 | $7,638.02 | $11,358.00 |