- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,328.89 / $1,465.48 / $4,846.00
| Facility | | $1,328.89 | $1,465.48 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,838.00 / $16,821.03 / $25,253.12
| Facility | | $4,838.00 | $16,821.03 | $25,253.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,245.65 / $1,709.72 / $2,747.78
| Facility | | $1,245.65 | $1,709.72 | $2,747.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $1,536.49
| Facility | | $761.00 | $761.00 | $1,536.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $5,995.00 / $9,243.00
| Facility | | $1,500.00 | $5,995.00 | $9,243.00 |