- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,348.42 / $9,022.44 / $12,102.80
| Facility | | $4,348.42 | $9,022.44 | $12,102.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,974.35 / $9,403.03 / $15,354.99
| Facility | | $6,974.35 | $9,403.03 | $15,354.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $8,390.54 / $9,976.75
| Facility | | $2,651.00 | $8,390.54 | $9,976.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,669.07 / $9,316.65 / $14,664.12
| Facility | | $7,669.07 | $9,316.65 | $14,664.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $11,510.48
| Facility | | $1,350.00 | $5,713.00 | $11,510.48 |