- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.16 / $8,739.36 / $15,070.05
| Facility | | $499.16 | $8,739.36 | $15,070.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,536.00 / $7,833.00 / $14,645.00
| Facility | | $3,536.00 | $7,833.00 | $14,645.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.91 / $698.70 / $1,048.05
| Facility | | $494.91 | $698.70 | $1,048.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,258.41 / $2,258.41 / $2,258.41
| Facility | | $2,258.41 | $2,258.41 | $2,258.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,957.58 / $6,741.00 / $10,769.00
| Facility | | $2,957.58 | $6,741.00 | $10,769.00 |