- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,005.00 / $10,225.00 / $16,469.00
| Facility | | $2,005.00 | $10,225.00 | $16,469.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,896.82 / $10,545.07 / $14,704.19
| Facility | | $7,896.82 | $10,545.07 | $14,704.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,890.80 / $10,989.46 / $17,613.48
| Facility | | $6,890.80 | $10,989.46 | $17,613.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,772.04 / $7,968.37 / $17,763.82
| Facility | | $3,772.04 | $7,968.37 | $17,763.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $10,719.78 / $15,820.78
| Facility | | $5,000.00 | $10,719.78 | $15,820.78 |