- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,097.81 / $3,245.38 / $14,063.00
| Facility | | $1,097.81 | $3,245.38 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,705.10 / $16,700.00 / $33,821.32
| Facility | | $2,705.10 | $16,700.00 | $33,821.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,093.72 / $1,501.18 / $2,251.77
| Facility | | $1,093.72 | $1,501.18 | $2,251.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,348.00 / $12,569.00
| Facility | | $3,932.00 | $8,348.00 | $12,569.00 |