- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,563.53 / $20,928.72
| Facility | | $5,005.00 | $10,563.53 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,669.97 / $18,367.90 / $32,234.47
| Facility | | $12,669.97 | $18,367.90 | $32,234.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,109.31 / $1,885.83 / $3,118.52
| Facility | | $1,109.31 | $1,885.83 | $3,118.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,993.00 / $2,758.34 / $3,890.82
| Facility | | $1,993.00 | $2,758.34 | $3,890.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |