- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.24 / $9,968.20 / $13,371.50
| Facility | | $4,804.24 | $9,968.20 | $13,371.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,472.36 / $12,472.36 / $21,083.48
| Facility | | $12,472.36 | $12,472.36 | $21,083.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $11,334.28 / $13,476.99
| Facility | | $2,651.00 | $11,334.28 | $13,476.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,472.96 / $10,293.25 / $16,201.26
| Facility | | $8,472.96 | $10,293.25 | $16,201.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $12,717.04
| Facility | | $1,350.00 | $5,713.00 | $12,717.04 |