- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,567.75 / $9,062.00 / $23,750.05
| Facility | | $1,567.75 | $9,062.00 | $23,750.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,927.58 / $6,852.09 / $12,492.30
| Facility | | $2,927.58 | $6,852.09 | $12,492.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $658.40 / $2,581.96
| Facility | | $580.00 | $658.40 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.41 / $831.90 / $1,274.25
| Facility | | $652.41 | $831.90 | $1,274.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |