- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,105.03 / $1,767.69 / $8,413.00
| Facility | | $1,105.03 | $1,767.69 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $5,006.99
| Facility | | $606.10 | $606.10 | $5,006.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,105.03 / $1,483.70 / $2,497.37
| Facility | | $1,105.03 | $1,483.70 | $2,497.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,714.38 / $7,714.38 / $26,542.00
| Facility | | $7,714.38 | $7,714.38 | $26,542.00 |