- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,828.05 / $12,092.50 / $16,221.00
| Facility | | $5,828.05 | $12,092.50 | $16,221.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,251.33 / $12,682.24 / $20,920.82
| Facility | | $7,251.33 | $12,682.24 | $20,920.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $11,900.88 / $14,150.70
| Facility | | $2,651.00 | $11,900.88 | $14,150.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,278.61 / $12,486.80 / $19,653.84
| Facility | | $10,278.61 | $12,486.80 | $19,653.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $15,427.11
| Facility | | $1,350.00 | $5,713.00 | $15,427.11 |