- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,168.69 / $11,220.18
| Facility | | $2,691.53 | $4,168.69 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $10,000.00 / $15,848.93
| Facility | | $6,918.31 | $10,000.00 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $5,623.41 / $7,585.78
| Facility | | $3,548.13 | $5,623.41 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $18,620.87 / $18,620.87
| Facility | | $16,218.10 | $18,620.87 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $5,754.40 / $8,912.51
| Facility | | $2,951.21 | $5,754.40 | $8,912.51 |