- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $12,914.60 / $20,794.09
| Facility | | $1,638.00 | $12,914.60 | $20,794.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,554.28 / $7,554.28 / $12,053.90
| Facility | | $7,554.28 | $7,554.28 | $12,053.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $2,080.03 / $8,805.70
| Facility | | $1,474.01 | $2,080.03 | $8,805.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,262.80 / $12,262.80 / $12,348.70
| Facility | | $12,262.80 | $12,262.80 | $12,348.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,171.62 / $11,325.37 / $23,784.67
| Facility | | $8,171.62 | $11,325.37 | $23,784.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,737.51 / $13,762.89 / $20,418.31
| Facility | | $8,737.51 | $13,762.89 | $20,418.31 |