- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,587.16 / $7,986.42 / $9,207.87
| Facility | | $6,587.16 | $7,986.42 | $9,207.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,164.77 / $15,566.44 / $21,926.07
| Facility | | $10,164.77 | $15,566.44 | $21,926.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,859.74 / $9,327.09 / $16,008.20
| Facility | | $5,859.74 | $9,327.09 | $16,008.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,251.54 / $13,864.35
| Facility | | $2,332.00 | $5,251.54 | $13,864.35 |