- 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
- $939.90 / $1,597.83 / $2,296.52
| Facility | | $939.90 | $1,597.83 | $2,296.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,654.00 / $2,304.92 / $3,113.41
| Facility | | $1,654.00 | $2,304.92 | $3,113.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |