- 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
- $7,838.93 / $11,364.26 / $19,943.52
| Facility | | $7,838.93 | $11,364.26 | $19,943.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $643.30 / $1,093.63 / $1,805.85
| Facility | | $643.30 | $1,093.63 | $1,805.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.05 / $1,628.47 / $3,137.00
| Facility | | $1,248.05 | $1,628.47 | $3,137.00 |
- 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 |