- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,535.50 / $8,477.27 / $20,928.72
| Facility | | $1,535.50 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,619.76 / $8,706.79 / $16,841.75
| Facility | | $6,619.76 | $8,706.79 | $16,841.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,535.50 / $2,763.90 / $9,696.00
| Facility | | $1,535.50 | $2,763.90 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,991.94 / $3,879.75 / $5,508.25
| Facility | | $1,991.94 | $3,879.75 | $5,508.25 |
- 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 |