- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,378.00 / $2,525.46 / $7,838.38
| Facility | | $1,378.00 | $2,525.46 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,696.56 / $11,573.82 / $18,875.38
| Facility | | $4,696.56 | $11,573.82 | $18,875.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.77 / $1,061.77 / $1,656.16
| Facility | | $1,061.77 | $1,061.77 | $1,656.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.41 / $1,046.34 / $1,406.48
| Facility | | $810.41 | $1,046.34 | $1,406.48 |
- 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 |