- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,568.27 / $9,400.16 / $16,541.59
| Facility | | $5,568.27 | $9,400.16 | $16,541.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,527.00 / $3,527.00 / $4,584.95
| Facility | | $3,527.00 | $3,527.00 | $4,584.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,762.93 / $4,054.76 / $6,707.70
| Facility | | $2,762.93 | $4,054.76 | $6,707.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,065.21 / $8,664.65 / $12,473.14
| Facility | | $5,065.21 | $8,664.65 | $12,473.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,598.65 / $17,598.65 / $20,653.50
| Facility | | $17,598.65 | $17,598.65 | $20,653.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $8,192.16 / $11,701.56
| Facility | | $1,787.00 | $8,192.16 | $11,701.56 |