- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,400.70 / $2,814.00 / $9,477.00
| Facility | | $1,400.70 | $2,814.00 | $9,477.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,242.09 / $9,242.09 / $11,090.51
| Facility | | $9,242.09 | $9,242.09 | $11,090.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,752.84 / $1,752.84 / $1,752.84
| Facility | | $1,752.84 | $1,752.84 | $1,752.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,726.62 / $4,726.62 / $4,726.62
| Facility | | $4,726.62 | $4,726.62 | $4,726.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $4,555.00 / $8,929.00
| Facility | | $2,000.00 | $4,555.00 | $8,929.00 |