- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,561.00 / $9,668.00 / $20,962.30
| Facility | | $1,561.00 | $9,668.00 | $20,962.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.88 / $9,936.96 / $11,643.04
| Facility | | $5,623.88 | $9,936.96 | $11,643.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,462.81 / $9,354.79 / $10,694.94
| Facility | | $7,462.81 | $9,354.79 | $10,694.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,388.10 / $11,307.60 / $14,706.02
| Facility | | $6,388.10 | $11,307.60 | $14,706.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,766.61 / $12,063.85 / $13,389.50
| Facility | | $5,766.61 | $12,063.85 | $13,389.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $5,687.00 / $12,746.04
| Facility | | $1,300.00 | $5,687.00 | $12,746.04 |