- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,973.00 / $9,794.67 / $17,897.00
| Facility | | $1,973.00 | $9,794.67 | $17,897.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,685.75 / $11,109.45 / $13,641.70
| Facility | | $9,685.75 | $11,109.45 | $13,641.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,666.09 / $9,984.16 / $16,886.86
| Facility | | $3,666.09 | $9,984.16 | $16,886.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,431.16 / $16,887.08 / $26,841.53
| Facility | | $10,431.16 | $16,887.08 | $26,841.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,320.36 / $16,033.41 / $23,410.09
| Facility | | $12,320.36 | $16,033.41 | $23,410.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,169.43 / $14,021.51 / $21,856.36
| Facility | | $8,169.43 | $14,021.51 | $21,856.36 |