- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,561.00 / $8,853.56 / $17,996.70
| Facility | | $1,561.00 | $8,853.56 | $17,996.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,459.76 / $6,550.00 / $9,726.23
| Facility | | $5,459.76 | $6,550.00 | $9,726.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,070.50 / $7,609.50 / $8,699.62
| Facility | | $6,070.50 | $7,609.50 | $8,699.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,484.34 / $9,707.85 / $12,625.48
| Facility | | $5,484.34 | $9,707.85 | $12,625.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,467.46 / $10,193.06 / $11,502.90
| Facility | | $6,467.46 | $10,193.06 | $11,502.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,857.00 / $7,785.46 / $12,401.12
| Facility | | $1,857.00 | $7,785.46 | $12,401.12 |