- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.85 / $7,333.32 / $11,322.00
| Facility | | $4,989.85 | $7,333.32 | $11,322.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,236.40 / $18,817.52 / $24,125.03
| Facility | | $13,236.40 | $18,817.52 | $24,125.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,615.90 / $10,857.81 / $13,733.16
| Facility | | $5,615.90 | $10,857.81 | $13,733.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.85 / $7,500.71 / $11,994.00
| Facility | | $4,989.85 | $7,500.71 | $11,994.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,835.57 / $9,978.89 / $15,160.84
| Facility | | $5,835.57 | $9,978.89 | $15,160.84 |