- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,820.79 / $11,022.70 / $17,748.00
| Facility | | $4,820.79 | $11,022.70 | $17,748.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,423.11 / $7,423.11 / $8,493.89
| Facility | | $7,423.11 | $7,423.11 | $8,493.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,968.58 / $16,062.74
| Facility | | $1,474.01 | $5,968.58 | $16,062.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,979.05 / $11,524.99 / $16,326.53
| Facility | | $7,979.05 | $11,524.99 | $16,326.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,974.57 / $9,666.33 / $20,300.48
| Facility | | $6,974.57 | $9,666.33 | $20,300.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,548.39 / $9,666.33 / $20,562.59
| Facility | | $6,548.39 | $9,666.33 | $20,562.59 |