- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,544.00 / $8,763.29 / $26,656.81
| Facility | | $1,544.00 | $8,763.29 | $26,656.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,761.63 / $14,198.51 / $23,155.91
| Facility | | $5,761.63 | $14,198.51 | $23,155.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.76 / $1,083.76 / $1,083.76
| Facility | | $1,083.76 | $1,083.76 | $1,083.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $908.12 / $1,124.21 / $1,421.06
| Facility | | $908.12 | $1,124.21 | $1,421.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.00 / $9,127.00 / $10,150.00
| Facility | | $1,230.00 | $9,127.00 | $10,150.00 |