- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,950.00 / $13,238.40 / $15,985.00
| Facility | | $6,950.00 | $13,238.40 | $15,985.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $11,954.00 / $20,519.18
| Facility | | $6,916.00 | $11,954.00 | $20,519.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,486.67 / $11,783.70 / $15,482.46
| Facility | | $10,486.67 | $11,783.70 | $15,482.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,356.71 / $9,793.00 / $16,291.10
| Facility | | $7,356.71 | $9,793.00 | $16,291.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,988.00 / $12,753.56 / $19,319.96
| Facility | | $7,988.00 | $12,753.56 | $19,319.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,242.67 / $11,086.55 / $14,278.38
| Facility | | $9,242.67 | $11,086.55 | $14,278.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $10,899.82 / $15,701.44
| Facility | | $3,775.00 | $10,899.82 | $15,701.44 |