- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,017.00 / $7,799.00 / $16,639.00
| Facility | | $1,017.00 | $7,799.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,197.05 / $8,155.06 / $14,268.09
| Facility | | $3,197.05 | $8,155.06 | $14,268.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,208.42 / $3,208.42 / $4,122.88
| Facility | | $3,208.42 | $3,208.42 | $4,122.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.82 / $1,046.64 / $1,744.00
| Facility | | $801.82 | $1,046.64 | $1,744.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,959.00 / $23,485.00
| Facility | | $2,912.00 | $16,959.00 | $23,485.00 |