- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,015.13 / $8,477.27 / $19,276.96
| Facility | | $3,015.13 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,110.54 / $7,110.54 / $7,110.54
| Facility | | $7,110.54 | $7,110.54 | $7,110.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $871.70 / $1,591.00 / $9,496.00
| Facility | | $871.70 | $1,591.00 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,658.00 / $2,342.55 / $8,919.81
| Facility | | $1,658.00 | $2,342.55 | $8,919.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,939.00 / $8,158.00 / $9,496.00
| Facility | | $6,939.00 | $8,158.00 | $9,496.00 |