- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,370.33 / $13,217.60 / $17,730.30
| Facility | | $6,370.33 | $13,217.60 | $17,730.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,322.06 / $12,966.51 / $16,805.55
| Facility | | $10,322.06 | $12,966.51 | $16,805.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $12,790.70 / $15,208.74
| Facility | | $2,651.00 | $12,790.70 | $15,208.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,234.99 / $13,648.65 / $21,482.56
| Facility | | $11,234.99 | $13,648.65 | $21,482.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $5,888.00 / $19,389.70
| Facility | | $1,500.00 | $5,888.00 | $19,389.70 |