- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,477.76 / $11,365.70 / $15,246.10
| Facility | | $5,477.76 | $11,365.70 | $15,246.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,174.95 / $11,285.27 / $21,601.30
| Facility | | $9,174.95 | $11,285.27 | $21,601.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $11,005.84 / $13,086.45
| Facility | | $2,651.00 | $11,005.84 | $13,086.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,660.83 / $11,736.30 / $18,472.58
| Facility | | $9,660.83 | $11,736.30 | $18,472.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $14,499.89
| Facility | | $1,350.00 | $5,713.00 | $14,499.89 |