- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $7,435.69 / $16,574.40
| Facility | | $2,318.00 | $7,435.69 | $16,574.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,171.61 / $11,591.83 / $18,468.75
| Facility | | $7,171.61 | $11,591.83 | $18,468.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,122.72 / $11,288.43 / $20,083.91
| Facility | | $7,122.72 | $11,288.43 | $20,083.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,730.00 / $8,253.19 / $23,749.26
| Facility | | $1,730.00 | $8,253.19 | $23,749.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,730.00 / $6,359.54 / $17,191.66
| Facility | | $1,730.00 | $6,359.54 | $17,191.66 |