- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,295.00 / $8,198.00 / $16,972.30
| Facility | | $2,295.00 | $8,198.00 | $16,972.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,002.34 / $10,002.34 / $12,714.57
| Facility | | $10,002.34 | $10,002.34 | $12,714.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,939.00 / $9,412.00 / $16,289.96
| Facility | | $2,939.00 | $9,412.00 | $16,289.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,093.73 / $12,041.28 / $19,408.07
| Facility | | $8,093.73 | $12,041.28 | $19,408.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,366.32 / $11,808.70 / $18,366.75
| Facility | | $7,366.32 | $11,808.70 | $18,366.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,674.00 / $10,968.00 / $19,135.30
| Facility | | $5,674.00 | $10,968.00 | $19,135.30 |