- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.57 / $9,483.36 / $12,721.10
| Facility | | $4,570.57 | $9,483.36 | $12,721.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,412.95 / $11,677.07 / $19,887.03
| Facility | | $10,412.95 | $11,677.07 | $19,887.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $9,578.94 / $11,389.81
| Facility | | $2,651.00 | $9,578.94 | $11,389.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,060.86 / $9,792.60 / $15,413.25
| Facility | | $8,060.86 | $9,792.60 | $15,413.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $12,098.50
| Facility | | $1,350.00 | $5,713.00 | $12,098.50 |