- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,053.00 / $12,825.30 / $19,602.09
| Facility | | $5,053.00 | $12,825.30 | $19,602.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,715.15 / $13,508.22 / $19,695.45
| Facility | | $8,715.15 | $13,508.22 | $19,695.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,340.67 / $12,837.00 / $23,340.00
| Facility | | $9,340.67 | $12,837.00 | $23,340.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $147.22 / $1,350.00
| Facility | | $100.00 | $147.22 | $1,350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,971.00 / $9,243.70 / $20,353.65
| Facility | | $3,971.00 | $9,243.70 | $20,353.65 |