- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,071.30 / $8,447.44 / $11,331.50
| Facility | | $4,071.30 | $8,447.44 | $11,331.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,767.54 / $9,143.74 / $18,237.93
| Facility | | $8,767.54 | $9,143.74 | $18,237.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $7,585.22 / $9,019.18
| Facility | | $2,651.00 | $7,585.22 | $9,019.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,180.32 / $8,722.90 / $13,729.58
| Facility | | $7,180.32 | $8,722.90 | $13,729.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,711.34 / $10,776.91
| Facility | | $1,350.00 | $5,711.34 | $10,776.91 |