- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,692.37 / $11,811.00 / $15,843.40
| Facility | | $5,692.37 | $11,811.00 | $15,843.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,554.57 / $14,587.31 / $25,466.22
| Facility | | $7,554.57 | $14,587.31 | $25,466.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $11,034.34 / $13,120.35
| Facility | | $2,651.00 | $11,034.34 | $13,120.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,039.32 / $12,196.10 / $19,196.29
| Facility | | $10,039.32 | $12,196.10 | $19,196.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,888.00 / $15,358.10
| Facility | | $1,350.00 | $5,888.00 | $15,358.10 |