- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $9,488.85 / $14,327.40
| Facility | | $4,804.00 | $9,488.85 | $14,327.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,753.00 / $10,049.26
| Facility | | $688.00 | $2,753.00 | $10,049.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,426.35 / $8,911.00 / $15,280.50
| Facility | | $5,426.35 | $8,911.00 | $15,280.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,528.60 / $20,507.34 / $20,507.34
| Facility | | $12,528.60 | $20,507.34 | $20,507.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,580.56 / $7,900.00 / $15,280.50
| Facility | | $5,580.56 | $7,900.00 | $15,280.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,033.60 / $7,078.40 / $16,182.99
| Facility | | $3,033.60 | $7,078.40 | $16,182.99 |