- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,167.44 / $8,689.96 / $10,019.00
| Facility | | $7,167.44 | $8,689.96 | $10,019.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,847.80 / $15,847.80 / $17,010.38
| Facility | | $15,847.80 | $15,847.80 | $17,010.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,375.94 / $10,148.74 / $17,418.41
| Facility | | $6,375.94 | $10,148.74 | $17,418.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $15,085.69
| Facility | | $2,332.00 | $5,310.00 | $15,085.69 |