- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,364.89 / $8,782.54 / $14,698.90
| Facility | | $6,364.89 | $8,782.54 | $14,698.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,512.28 / $14,144.16 / $16,464.77
| Facility | | $9,512.28 | $14,144.16 | $16,464.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $10,027.62 / $15,444.16
| Facility | | $2,423.00 | $10,027.62 | $15,444.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,514.41 / $10,379.82 / $16,569.93
| Facility | | $6,514.41 | $10,379.82 | $16,569.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $7,974.30 / $17,731.78
| Facility | | $2,600.00 | $7,974.30 | $17,731.78 |