- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $10,517.50 / $12,164.00
| Facility | | $3,822.00 | $10,517.50 | $12,164.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $7,963.00 / $19,820.03
| Facility | | $3,400.00 | $7,963.00 | $19,820.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,942.75 / $9,826.46 / $14,847.91
| Facility | | $5,942.75 | $9,826.46 | $14,847.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,438.00 / $8,148.00 / $13,954.59
| Facility | | $4,438.00 | $8,148.00 | $13,954.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,562.34 / $9,899.28 / $15,286.81
| Facility | | $8,562.34 | $9,899.28 | $15,286.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $7,963.00 / $19,820.03
| Facility | | $3,400.00 | $7,963.00 | $19,820.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,400.00 / $7,170.00 / $11,300.27
| Facility | | $3,400.00 | $7,170.00 | $11,300.27 |