- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,144.77 / $10,674.80 / $14,319.30
| Facility | | $5,144.77 | $10,674.80 | $14,319.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,461.01 / $15,539.47 / $19,077.78
| Facility | | $11,461.01 | $15,539.47 | $19,077.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $11,720.31 / $13,935.99
| Facility | | $2,651.00 | $11,720.31 | $13,935.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,073.54 / $11,022.85 / $17,349.63
| Facility | | $9,073.54 | $11,022.85 | $17,349.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $13,618.44
| Facility | | $1,350.00 | $5,713.00 | $13,618.44 |