- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,262.39 / $8,843.95 / $11,863.40
| Facility | | $4,262.39 | $8,843.95 | $11,863.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,011.52 / $9,710.90 / $12,549.07
| Facility | | $9,011.52 | $9,710.90 | $12,549.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $7,516.06 / $8,936.94
| Facility | | $2,651.00 | $7,516.06 | $8,936.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,517.37 / $9,132.35 / $14,374.04
| Facility | | $7,517.37 | $9,132.35 | $14,374.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,888.00 / $11,500.03
| Facility | | $1,350.00 | $5,888.00 | $11,500.03 |