- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,527.10 / $9,393.20 / $12,600.20
| Facility | | $4,527.10 | $9,393.20 | $12,600.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,296.04 / $10,547.83 / $21,362.27
| Facility | | $10,296.04 | $10,547.83 | $21,362.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $8,661.64 / $10,299.09
| Facility | | $2,651.00 | $8,661.64 | $10,299.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,984.22 / $9,699.50 / $15,266.72
| Facility | | $7,984.22 | $9,699.50 | $15,266.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $11,983.48
| Facility | | $1,350.00 | $5,713.00 | $11,983.48 |