- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.88 / $3,779.00 / $12,600.00
| Facility | | $1,187.88 | $3,779.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,334.45 / $14,829.12 / $23,429.85
| Facility | | $9,334.45 | $14,829.12 | $23,429.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,703.09 / $4,703.09 / $4,703.09
| Facility | | $4,703.09 | $4,703.09 | $4,703.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.88 / $1,641.61 / $7,567.45
| Facility | | $1,187.88 | $1,641.61 | $7,567.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,910.00 / $9,232.95
| Facility | | $1,481.00 | $5,910.00 | $9,232.95 |