- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,051.27 / $4,703.67 / $11,093.00
| Facility | | $1,051.27 | $4,703.67 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,039.26 / $1,426.43 / $2,139.65
| Facility | | $1,039.26 | $1,426.43 | $2,139.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,206.74 / $6,206.74 / $7,357.48
| Facility | | $6,206.74 | $6,206.74 | $7,357.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |