- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.79 / $7,186.00 / $12,317.09
| Facility | | $1,023.79 | $7,186.00 | $12,317.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $5,006.99
| Facility | | $748.70 | $748.70 | $5,006.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.79 / $1,359.39 / $2,256.96
| Facility | | $1,023.79 | $1,359.39 | $2,256.96 |
- 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
- $5,812.26 / $16,547.20 / $26,542.00
| Facility | | $5,812.26 | $16,547.20 | $26,542.00 |