- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,109.67 / $4,380.00 / $17,893.25
| Facility | | $1,109.67 | $4,380.00 | $17,893.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,410.13 / $11,345.35 / $24,108.80
| Facility | | $5,410.13 | $11,345.35 | $24,108.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,795.47 / $3,964.33 / $9,536.73
| Facility | | $2,795.47 | $3,964.33 | $9,536.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,272.52 / $3,624.35 / $7,509.24
| Facility | | $2,272.52 | $3,624.35 | $7,509.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,250.73 / $2,066.42 / $11,102.92
| Facility | | $1,250.73 | $2,066.42 | $11,102.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |