- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $5,915.00 / $14,100.00
| Facility | | $1,456.00 | $5,915.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,954.18 / $11,047.74 / $17,455.31
| Facility | | $6,954.18 | $11,047.74 | $17,455.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,174.64 / $14,174.64 / $14,174.64
| Facility | | $14,174.64 | $14,174.64 | $14,174.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.73 / $1,252.97 / $8,986.49
| Facility | | $914.73 | $1,252.97 | $8,986.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,973.00 / $10,811.00
| Facility | | $1,481.00 | $5,973.00 | $10,811.00 |