- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,563.53 / $20,928.72
| Facility | | $5,005.00 | $10,563.53 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,193.47 / $8,393.75 / $15,757.21
| Facility | | $6,193.47 | $8,393.75 | $15,757.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,024.51 / $1,792.89 / $9,855.12
| Facility | | $1,024.51 | $1,792.89 | $9,855.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,007.16 / $2,718.97 / $5,383.60
| Facility | | $2,007.16 | $2,718.97 | $5,383.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |