- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $11,548.30 / $18,594.30
| Facility | | $1,638.00 | $11,548.30 | $18,594.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,728.62 / $10,364.03 / $15,103.33
| Facility | | $8,728.62 | $10,364.03 | $15,103.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $2,555.21 / $9,243.00
| Facility | | $1,474.01 | $2,555.21 | $9,243.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,965.48 / $10,965.48 / $11,042.30
| Facility | | $10,965.48 | $10,965.48 | $11,042.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,307.12 / $10,127.23 / $21,268.43
| Facility | | $7,307.12 | $10,127.23 | $21,268.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,860.63 / $10,127.23 / $21,543.05
| Facility | | $6,860.63 | $10,127.23 | $21,543.05 |