- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $4,778.89 / $13,841.56
| Facility | | $1,653.00 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,732.29 / $13,189.77 / $24,760.56
| Facility | | $9,732.29 | $13,189.77 | $24,760.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.50 / $1,592.34 / $4,293.37
| Facility | | $297.50 | $1,592.34 | $4,293.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $610.05 / $2,364.62 / $3,310.62
| Facility | | $610.05 | $2,364.62 | $3,310.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |