- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,442.00 / $8,881.83 / $15,304.60
| Facility | | $6,442.00 | $8,881.83 | $15,304.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,930.26 / $9,930.26 / $17,117.84
| Facility | | $9,930.26 | $9,930.26 | $17,117.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,441.00 / $10,743.46 / $16,546.66
| Facility | | $2,441.00 | $10,743.46 | $16,546.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,955.11 / $10,419.56 / $17,550.71
| Facility | | $5,955.11 | $10,419.56 | $17,550.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,150.00 / $8,408.85 / $18,531.99
| Facility | | $2,150.00 | $8,408.85 | $18,531.99 |