- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,960.10 / $8,438.59 / $9,729.20
| Facility | | $6,960.10 | $8,438.59 | $9,729.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,528.86 / $10,768.79 / $26,513.31
| Facility | | $10,528.86 | $10,768.79 | $26,513.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,191.50 / $9,855.16 / $16,914.54
| Facility | | $6,191.50 | $9,855.16 | $16,914.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $14,649.30
| Facility | | $2,332.00 | $5,310.00 | $14,649.30 |