- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,686.38 / $7,846.30 / $13,131.90
| Facility | | $5,686.38 | $7,846.30 | $13,131.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,789.62 / $9,789.62 / $17,931.84
| Facility | | $9,789.62 | $9,789.62 | $17,931.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $9,086.98 / $13,995.42
| Facility | | $2,423.00 | $9,086.98 | $13,995.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,819.96 / $8,827.43 / $14,803.54
| Facility | | $5,819.96 | $8,827.43 | $14,803.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $7,124.22 / $15,841.53
| Facility | | $2,600.00 | $7,124.22 | $15,841.53 |