- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,912.51 / $12,302.69
| Facility | | $2,344.23 | $8,912.51 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,365.16 / $16,982.44
| Facility | | $2,238.72 | $4,365.16 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,513.56 / $3,311.31
| Facility | | $1,513.56 | $1,513.56 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $1,445.44 / $6,456.54
| Facility | | $100.00 | $1,445.44 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $6,606.93 / $10,964.78
| Facility | | $3,235.94 | $6,606.93 | $10,964.78 |