- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,101.98 / $1,791.67 / $10,453.00
| Facility | | $1,101.98 | $1,791.67 | $10,453.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $7,637.23
| Facility | | $748.70 | $748.70 | $7,637.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,111.98 / $1,629.00 / $2,564.79
| Facility | | $1,111.98 | $1,629.00 | $2,564.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,111.68 / $5,571.28 / $26,542.00
| Facility | | $5,111.68 | $5,571.28 | $26,542.00 |