- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,053.00 / $10,994.40 / $16,803.70
| Facility | | $5,053.00 | $10,994.40 | $16,803.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,323.66 / $11,593.05 / $17,272.00
| Facility | | $7,323.66 | $11,593.05 | $17,272.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,007.20 / $11,004.40 / $20,008.00
| Facility | | $8,007.20 | $11,004.40 | $20,008.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.61 / $126.21 / $1,350.00
| Facility | | $88.61 | $126.21 | $1,350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,971.00 / $8,819.53 / $17,447.98
| Facility | | $3,971.00 | $8,819.53 | $17,447.98 |