- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,617.48 / $10,448.00 / $12,046.00
| Facility | | $8,617.48 | $10,448.00 | $12,046.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,178.30 / $13,178.30 / $18,122.46
| Facility | | $13,178.30 | $13,178.30 | $18,122.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $8,731.00
| Facility | | $1,252.00 | $3,715.00 | $8,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,665.86 / $12,201.93 / $20,942.34
| Facility | | $7,665.86 | $12,201.93 | $20,942.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $12,179.47 / $18,439.04
| Facility | | $3,137.00 | $12,179.47 | $18,439.04 |