- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.00 / $12,186.32 / $25,217.30
| Facility | | $1,584.00 | $12,186.32 | $25,217.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,329.98 / $9,329.98 / $18,447.75
| Facility | | $9,329.98 | $9,329.98 | $18,447.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,531.97 / $10,709.31 / $15,373.80
| Facility | | $5,531.97 | $10,709.31 | $15,373.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,379.85 / $12,566.23 / $22,017.71
| Facility | | $9,379.85 | $12,566.23 | $22,017.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,535.00 / $10,244.00 / $18,489.74
| Facility | | $3,535.00 | $10,244.00 | $18,489.74 |