- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,954.29 / $14,429.30 / $19,355.59
| Facility | | $6,954.29 | $14,429.30 | $19,355.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,969.61 / $13,610.61 / $26,552.33
| Facility | | $10,969.61 | $13,610.61 | $26,552.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $11,006.40 / $13,087.13
| Facility | | $2,651.00 | $11,006.40 | $13,087.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,264.89 / $14,899.80 / $23,451.83
| Facility | | $12,264.89 | $14,899.80 | $23,451.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,888.00 / $18,408.31
| Facility | | $1,350.00 | $5,888.00 | $18,408.31 |