- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $4,434.60 / $12,600.00
| Facility | | $1,150.00 | $4,434.60 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,276.54 / $14,509.07 / $22,756.67
| Facility | | $9,276.54 | $14,509.07 | $22,756.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,461.30 / $7,461.30 / $7,461.30
| Facility | | $7,461.30 | $7,461.30 | $7,461.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $698.24 / $1,047.22 / $8,986.49
| Facility | | $698.24 | $1,047.22 | $8,986.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,910.00 / $9,232.95
| Facility | | $1,481.00 | $5,910.00 | $9,232.95 |