- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,280.14 / $8,880.76 / $11,912.80
| Facility | | $4,280.14 | $8,880.76 | $11,912.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,490.22 / $13,490.22 / $18,011.75
| Facility | | $13,490.22 | $13,490.22 | $18,011.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $7,703.79 / $9,160.16
| Facility | | $2,651.00 | $7,703.79 | $9,160.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,548.65 / $9,170.35 / $14,433.85
| Facility | | $7,548.65 | $9,170.35 | $14,433.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $11,329.73
| Facility | | $1,350.00 | $5,713.00 | $11,329.73 |