- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,185.00 / $10,429.70 / $18,594.30
| Facility | | $2,185.00 | $10,429.70 | $18,594.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,335.00 / $9,504.00 / $13,810.96
| Facility | | $1,335.00 | $9,504.00 | $13,810.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,618.53 / $9,879.33 / $16,919.29
| Facility | | $4,618.53 | $9,879.33 | $16,919.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,748.37 / $9,720.10 / $13,819.68
| Facility | | $8,748.37 | $9,720.10 | $13,819.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,001.25 / $11,992.90 / $29,812.46
| Facility | | $6,001.25 | $11,992.90 | $29,812.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,001.25 / $11,450.39 / $16,092.95
| Facility | | $6,001.25 | $11,450.39 | $16,092.95 |