- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.55 / $9,622.00 / $18,276.00
| Facility | | $1,154.55 | $9,622.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,717.57 / $9,950.93 / $16,952.09
| Facility | | $4,717.57 | $9,950.93 | $16,952.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,128.18 / $1,130.00 / $6,756.46
| Facility | | $1,128.18 | $1,130.00 | $6,756.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,024.00 / $1,276.36 / $2,289.23
| Facility | | $1,024.00 | $1,276.36 | $2,289.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |