- 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
- $6,810.78 / $8,958.04 / $17,327.75
| Facility | | $6,810.78 | $8,958.04 | $17,327.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,634.43 / $4,634.43 / $4,634.43
| Facility | | $4,634.43 | $4,634.43 | $4,634.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $990.91 / $1,763.64 / $8,632.00
| Facility | | $990.91 | $1,763.64 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,335.00 / $2,650.76 / $7,417.76
| Facility | | $1,335.00 | $2,650.76 | $7,417.76 |
- 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 |