- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $12,870.10 / $22,968.00
| Facility | | $3,182.00 | $12,870.10 | $22,968.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,920.41 / $9,291.19 / $11,956.65
| Facility | | $5,920.41 | $9,291.19 | $11,956.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,436.86 / $18,353.54
| Facility | | $1,474.01 | $7,436.86 | $18,353.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,316.29 / $13,456.51 / $19,062.75
| Facility | | $9,316.29 | $13,456.51 | $19,062.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,143.46 / $13,770.05 / $24,207.00
| Facility | | $8,143.46 | $13,770.05 | $24,207.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,645.86 / $13,126.00 / $21,781.00
| Facility | | $7,645.86 | $13,126.00 | $21,781.00 |