- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,646.06 / $7,790.67 / $13,038.80
| Facility | | $5,646.06 | $7,790.67 | $13,038.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,145.61 / $12,198.21 / $16,994.89
| Facility | | $7,145.61 | $12,198.21 | $16,994.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $9,175.68 / $13,928.60
| Facility | | $2,423.00 | $9,175.68 | $13,928.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,778.70 / $8,764.84 / $14,698.58
| Facility | | $5,778.70 | $8,764.84 | $14,698.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $7,073.71 / $15,729.21
| Facility | | $2,600.00 | $7,073.71 | $15,729.21 |