- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,955.87 / $10,858.30 / $12,519.00
| Facility | | $8,955.87 | $10,858.30 | $12,519.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,262.65 / $13,857.87 / $17,172.29
| Facility | | $11,262.65 | $13,857.87 | $17,172.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,966.88 / $12,681.08 / $21,764.69
| Facility | | $7,966.88 | $12,681.08 | $21,764.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $18,849.91
| Facility | | $2,332.00 | $5,310.00 | $18,849.91 |