- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,622.87 / $11,667.00 / $13,451.40
| Facility | | $9,622.87 | $11,667.00 | $13,451.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,965.62 / $11,801.00 / $13,365.56
| Facility | | $9,965.62 | $11,801.00 | $13,365.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,371.29 / $10,439.04 / $20,767.39
| Facility | | $8,371.29 | $10,439.04 | $20,767.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.00 / $2,156.00 / $12,657.32
| Facility | | $477.00 | $2,156.00 | $12,657.32 |