- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,177.00 / $17,352.20 / $24,004.70
| Facility | | $5,177.00 | $17,352.20 | $24,004.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $8,523.70
| Facility | | $1,146.00 | $3,000.00 | $8,523.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,531.13 / $9,024.03 / $16,738.28
| Facility | | $6,531.13 | $9,024.03 | $16,738.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,531.13 / $9,318.60 / $16,738.28
| Facility | | $6,531.13 | $9,318.60 | $16,738.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,866.38 / $12,195.03 / $17,908.28
| Facility | | $4,866.38 | $12,195.03 | $17,908.28 |