- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,700.80 / $9,492.79 / $15,972.50
| Facility | | $6,700.80 | $9,492.79 | $15,972.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,932.29 / $12,537.02 / $15,057.10
| Facility | | $9,932.29 | $12,537.02 | $15,057.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,790.00 / $3,447.00 / $9,550.89
| Facility | | $1,790.00 | $3,447.00 | $9,550.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,201.13 / $10,922.30 / $18,316.64
| Facility | | $7,201.13 | $10,922.30 | $18,316.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,787.00 / $7,344.08 / $16,888.25
| Facility | | $2,787.00 | $7,344.08 | $16,888.25 |