- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,683.18 / $9,717.04 / $13,034.60
| Facility | | $4,683.18 | $9,717.04 | $13,034.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,875.46 / $10,476.78 / $14,259.84
| Facility | | $9,875.46 | $10,476.78 | $14,259.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $9,917.61 / $11,792.50
| Facility | | $2,651.00 | $9,917.61 | $11,792.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,259.48 / $10,033.90 / $15,793.05
| Facility | | $8,259.48 | $10,033.90 | $15,793.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $12,396.62
| Facility | | $1,350.00 | $5,713.00 | $12,396.62 |