- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $12,879.70 / $20,738.00
| Facility | | $1,638.00 | $12,879.70 | $20,738.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $2,555.21 / $11,544.93
| Facility | | $1,474.01 | $2,555.21 | $11,544.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,229.68 / $12,229.68 / $12,315.35
| Facility | | $12,229.68 | $12,229.68 | $12,315.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,149.55 / $11,294.78 / $23,720.44
| Facility | | $8,149.55 | $11,294.78 | $23,720.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,651.58 / $11,294.78 / $24,026.71
| Facility | | $7,651.58 | $11,294.78 | $24,026.71 |