- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $6,354.55 / $16,762.57
| Facility | | $1,615.00 | $6,354.55 | $16,762.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,522.03 / $5,947.70 / $11,504.78
| Facility | | $4,522.03 | $5,947.70 | $11,504.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.91 / $1,196.83 / $5,405.32
| Facility | | $629.91 | $1,196.83 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,577.85 / $2,961.89
| Facility | | $1,089.00 | $1,577.85 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,529.66 / $6,178.00 / $8,816.00
| Facility | | $2,529.66 | $6,178.00 | $8,816.00 |