- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $8,477.27 / $19,276.96
| Facility | | $4,382.00 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,281.85 / $5,631.80 / $10,893.72
| Facility | | $4,281.85 | $5,631.80 | $10,893.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.70 / $1,447.62 / $6,817.20
| Facility | | $640.70 | $1,447.62 | $6,817.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,600.33 / $2,283.61
| Facility | | $1,089.00 | $1,600.33 | $2,283.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |