- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,828.40 / $10,296.48 / $19,916.72
| Facility | | $7,828.40 | $10,296.48 | $19,916.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.19 / $1,420.54 / $9,496.00
| Facility | | $789.19 | $1,420.54 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.83 / $1,911.00 / $2,487.39
| Facility | | $977.83 | $1,911.00 | $2,487.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |