- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,184.40 / $9,736.70 / $18,278.29
| Facility | | $7,184.40 | $9,736.70 | $18,278.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $745.61 / $1,204.83 / $6,451.00
| Facility | | $745.61 | $1,204.83 | $6,451.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.91 / $1,877.72 / $5,251.23
| Facility | | $1,387.91 | $1,877.72 | $5,251.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |