- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,053.00 / $10,518.50 / $16,009.40
| Facility | | $5,053.00 | $10,518.50 | $16,009.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,008.74 / $11,094.54 / $16,654.86
| Facility | | $7,008.74 | $11,094.54 | $16,654.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,660.63 / $10,528.10 / $19,142.00
| Facility | | $7,660.63 | $10,528.10 | $19,142.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.77 / $120.75 / $2,650.00
| Facility | | $84.77 | $120.75 | $2,650.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,971.00 / $8,615.00 / $16,692.78
| Facility | | $3,971.00 | $8,615.00 | $16,692.78 |