- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,002.13 / $8,303.92 / $11,139.00
| Facility | | $4,002.13 | $8,303.92 | $11,139.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,226.29 / $10,751.20 / $12,428.96
| Facility | | $6,226.29 | $10,751.20 | $12,428.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $6,510.85 / $7,741.70
| Facility | | $2,651.00 | $6,510.85 | $7,741.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,058.33 / $8,574.70 / $13,496.32
| Facility | | $7,058.33 | $8,574.70 | $13,496.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $10,593.82
| Facility | | $1,350.00 | $5,713.00 | $10,593.82 |