- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,479.67 / $9,294.76 / $12,468.10
| Facility | | $4,479.67 | $9,294.76 | $12,468.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,477.16 / $10,020.51 / $21,927.09
| Facility | | $9,477.16 | $10,020.51 | $21,927.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $9,061.29 / $10,774.30
| Facility | | $2,651.00 | $9,061.29 | $10,774.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,900.55 / $9,597.85 / $15,106.72
| Facility | | $7,900.55 | $9,597.85 | $15,106.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $11,857.89
| Facility | | $1,350.00 | $5,713.00 | $11,857.89 |