- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,840.30 / $9,505.76 / $10,959.60
| Facility | | $7,840.30 | $9,505.76 | $10,959.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,319.56 / $11,319.56 / $21,846.17
| Facility | | $11,319.56 | $11,319.56 | $21,846.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,974.50 / $11,101.48 / $19,053.61
| Facility | | $6,974.50 | $11,101.48 | $19,053.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,046.00 / $5,121.00 / $16,501.91
| Facility | | $1,046.00 | $5,121.00 | $16,501.91 |