- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,614.06 / $9,231.45 / $10,643.30
| Facility | | $7,614.06 | $9,231.45 | $10,643.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,942.25 / $13,942.25 / $13,942.25
| Facility | | $13,942.25 | $13,942.25 | $13,942.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,702.00 / $6,578.00
| Facility | | $1,252.00 | $3,702.00 | $6,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,773.24 / $10,781.13 / $18,503.79
| Facility | | $6,773.24 | $10,781.13 | $18,503.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $10,491.52 / $16,291.98
| Facility | | $3,137.00 | $10,491.52 | $16,291.98 |