- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.64 / $11,668.40 / $15,652.10
| Facility | | $5,623.64 | $11,668.40 | $15,652.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,524.19 / $11,136.45 / $15,670.22
| Facility | | $9,524.19 | $11,136.45 | $15,670.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $10,126.24 / $12,040.57
| Facility | | $2,651.00 | $10,126.24 | $12,040.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,918.11 / $12,048.85 / $18,964.52
| Facility | | $9,918.11 | $12,048.85 | $18,964.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $14,886.04
| Facility | | $1,350.00 | $5,713.00 | $14,886.04 |