- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,348.70 / $7,380.36 / $12,352.10
| Facility | | $5,348.70 | $7,380.36 | $12,352.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,133.98 / $11,982.55 / $15,068.00
| Facility | | $8,133.98 | $11,982.55 | $15,068.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $8,492.42 / $13,079.70
| Facility | | $2,423.00 | $8,492.42 | $13,079.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,348.70 / $8,303.21 / $13,924.45
| Facility | | $5,348.70 | $8,303.21 | $13,924.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $6,701.16 / $14,949.19
| Facility | | $2,600.00 | $6,701.16 | $14,949.19 |