- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,971.52 / $5,480.07 / $9,171.69
| Facility | | $3,971.52 | $5,480.07 | $9,171.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,010.21 / $17,010.21 / $17,010.21
| Facility | | $17,010.21 | $17,010.21 | $17,010.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $6,394.01 / $9,667.41
| Facility | | $2,423.00 | $6,394.01 | $9,667.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,064.82 / $6,165.31 / $10,339.19
| Facility | | $4,064.82 | $6,165.31 | $10,339.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $4,975.75 / $11,064.15
| Facility | | $2,600.00 | $4,975.75 | $11,064.15 |