- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,316.00 / $10,104.00 / $18,834.80
| Facility | | $4,316.00 | $10,104.00 | $18,834.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,308.00 / $10,702.01 / $14,715.30
| Facility | | $2,308.00 | $10,702.01 | $14,715.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.56 / $10,149.46 / $14,760.62
| Facility | | $2,884.56 | $10,149.46 | $14,760.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,863.09 / $15,527.99 / $22,736.87
| Facility | | $10,863.09 | $15,527.99 | $22,736.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,300.00 / $9,753.00 / $21,978.84
| Facility | | $3,300.00 | $9,753.00 | $21,978.84 |