- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,073.00 / $5,437.00 / $10,407.00
| Facility | | $2,073.00 | $5,437.00 | $10,407.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.75 / $6,640.00 / $10,860.55
| Facility | | $1,763.75 | $6,640.00 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,019.71 / $9,019.71 / $9,019.71
| Facility | | $9,019.71 | $9,019.71 | $9,019.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,218.78 / $1,785.77 / $9,383.00
| Facility | | $1,218.78 | $1,785.77 | $9,383.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |