- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,232.84 / $2,031.00 / $11,895.12
| Facility | | $1,232.84 | $2,031.00 | $11,895.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,727.30 / $6,727.30 / $8,072.76
| Facility | | $6,727.30 | $6,727.30 | $8,072.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,254.39 / $1,366.60 / $3,833.20
| Facility | | $1,254.39 | $1,366.60 | $3,833.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,607.09 / $6,607.09 / $6,607.09
| Facility | | $6,607.09 | $6,607.09 | $6,607.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,104.00 / $4,334.00 / $8,676.00
| Facility | | $2,104.00 | $4,334.00 | $8,676.00 |