- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,862.00 / $7,088.65 / $9,637.10
| Facility | | $2,862.00 | $7,088.65 | $9,637.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,778.00 / $15,108.00 / $20,578.61
| Facility | | $11,778.00 | $15,108.00 | $20,578.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.00 / $9,619.46 / $9,619.46
| Facility | | $843.00 | $9,619.46 | $9,619.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,330.14 / $4,873.00 / $4,974.00
| Facility | | $4,330.14 | $4,873.00 | $4,974.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,943.00 / $10,336.00 / $17,069.00
| Facility | | $6,943.00 | $10,336.00 | $17,069.00 |