- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,948.50 / $7,666.80 / $15,581.00
| Facility | | $5,948.50 | $7,666.80 | $15,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,427.67 / $9,427.67 / $9,427.67
| Facility | | $9,427.67 | $9,427.67 | $9,427.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,834.78 / $7,314.02 / $8,361.82
| Facility | | $5,834.78 | $7,314.02 | $8,361.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,748.17 / $8,404.76 / $10,930.76
| Facility | | $4,748.17 | $8,404.76 | $10,930.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,841.82 / $10,841.82 / $10,841.82
| Facility | | $10,841.82 | $10,841.82 | $10,841.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,740.41 / $10,380.40
| Facility | | $1,286.00 | $6,740.41 | $10,380.40 |