- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,374.00 / $8,126.00 / $11,955.60
| Facility | | $2,374.00 | $8,126.00 | $11,955.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,768.43 / $9,199.94 / $14,262.11
| Facility | | $6,768.43 | $9,199.94 | $14,262.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,891.00 / $8,207.00 / $12,610.89
| Facility | | $2,891.00 | $8,207.00 | $12,610.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,701.38 / $8,318.28 / $13,671.43
| Facility | | $5,701.38 | $8,318.28 | $13,671.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,572.67 / $9,479.37 / $13,554.69
| Facility | | $5,572.67 | $9,479.37 | $13,554.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,158.00 / $9,657.92 / $14,204.72
| Facility | | $5,158.00 | $9,657.92 | $14,204.72 |