- 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
- $7,218.81 / $10,465.26 / $18,365.84
| Facility | | $7,218.81 | $10,465.26 | $18,365.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $903.69 / $1,527.24 / $2,147.94
| Facility | | $903.69 | $1,527.24 | $2,147.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,592.00 / $2,195.75 / $2,994.12
| Facility | | $1,592.00 | $2,195.75 | $2,994.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,700.00 / $6,178.00 / $8,632.00
| Facility | | $4,700.00 | $6,178.00 | $8,632.00 |