- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,056.70 / $1,386.00 / $11,093.00
| Facility | | $1,056.70 | $1,386.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,309.00 / $7,200.00 / $15,727.00
| Facility | | $3,309.00 | $7,200.00 | $15,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.82 / $1,327.07 / $1,602.69
| Facility | | $1,020.82 | $1,327.07 | $1,602.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,909.74 / $3,909.74 / $4,634.62
| Facility | | $3,909.74 | $3,909.74 | $4,634.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,472.00 / $10,113.00 / $15,750.00
| Facility | | $4,472.00 | $10,113.00 | $15,750.00 |