- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,730.43 / $1,730.43 / $7,397.00
| Facility | | $1,730.43 | $1,730.43 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,373.31 / $32,422.94 / $66,228.75
| Facility | | $8,373.31 | $32,422.94 | $66,228.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,188.95 / $5,943.51 / $14,297.91
| Facility | | $4,188.95 | $5,943.51 | $14,297.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,808.13 / $5,433.79 / $11,258.20
| Facility | | $3,808.13 | $5,433.79 | $11,258.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,783.54 / $3,245.48 / $11,496.00
| Facility | | $1,783.54 | $3,245.48 | $11,496.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,028.00 / $11,496.00 / $21,528.00
| Facility | | $5,028.00 | $11,496.00 | $21,528.00 |