- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,782.40 / $5,516.00 / $8,954.20
| Facility | | $3,782.40 | $5,516.00 | $8,954.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,516.51 / $13,529.13 / $17,345.04
| Facility | | $9,516.51 | $13,529.13 | $17,345.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,441.43 / $8,587.08 / $10,861.10
| Facility | | $4,441.43 | $8,587.08 | $10,861.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,946.30 / $5,932.06 / $9,485.62
| Facility | | $3,946.30 | $5,932.06 | $9,485.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,615.16 / $7,891.98 / $11,990.21
| Facility | | $4,615.16 | $7,891.98 | $11,990.21 |