- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,487.00 / $9,111.64 / $24,835.90
| Facility | | $3,487.00 | $9,111.64 | $24,835.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,405.29 / $11,110.48 / $18,126.20
| Facility | | $7,405.29 | $11,110.48 | $18,126.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,064.55 / $12,272.91 / $18,102.24
| Facility | | $7,064.55 | $12,272.91 | $18,102.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,669.65 / $20,722.38 / $30,111.02
| Facility | | $17,669.65 | $20,722.38 | $30,111.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,820.00 / $7,583.00 / $16,525.61
| Facility | | $2,820.00 | $7,583.00 | $16,525.61 |