- 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
- $4,474.97 / $6,064.74 / $11,385.07
| Facility | | $4,474.97 | $6,064.74 | $11,385.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.39 / $1,212.94 / $10,946.80
| Facility | | $680.39 | $1,212.94 | $10,946.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.00 / $1,518.19 / $2,152.40
| Facility | | $1,083.00 | $1,518.19 | $2,152.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |