- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,080.07 / $4,376.00 / $7,278.00
| Facility | | $1,080.07 | $4,376.00 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $5,302.65
| Facility | | $530.04 | $530.04 | $5,302.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,080.07 / $1,406.92 / $2,440.96
| Facility | | $1,080.07 | $1,406.92 | $2,440.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,952.78 / $16,394.00 / $18,039.43
| Facility | | $5,952.78 | $16,394.00 | $18,039.43 |