- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $16,799.30 / $27,049.00
| Facility | | $1,638.00 | $16,799.30 | $27,049.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,607.22 / $15,240.05 / $17,591.45
| Facility | | $10,607.22 | $15,240.05 | $17,591.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $2,555.21 / $13,251.33
| Facility | | $1,474.01 | $2,555.21 | $13,251.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,951.46 / $15,951.46 / $16,063.20
| Facility | | $15,951.46 | $15,951.46 | $16,063.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,629.65 / $14,732.05 / $30,939.12
| Facility | | $10,629.65 | $14,732.05 | $30,939.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,980.14 / $14,732.05 / $31,338.60
| Facility | | $9,980.14 | $14,732.05 | $31,338.60 |