- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,097.33 / $9,062.00 / $17,196.84
| Facility | | $1,097.33 | $9,062.00 | $17,196.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,272.30 / $7,624.59 / $17,063.65
| Facility | | $3,272.30 | $7,624.59 | $17,063.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,085.08 / $2,345.00 / $7,750.61
| Facility | | $1,085.08 | $2,345.00 | $7,750.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,059.85 / $1,218.82 / $2,113.08
| Facility | | $1,059.85 | $1,218.82 | $2,113.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,766.00 / $17,146.00 / $24,729.00
| Facility | | $8,766.00 | $17,146.00 | $24,729.00 |