- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,098.00 / $5,463.36 / $13,841.56
| Facility | | $1,098.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,833.84 / $6,306.95 / $12,298.09
| Facility | | $4,833.84 | $6,306.95 | $12,298.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,380.56 / $2,380.56 / $2,380.56
| Facility | | $2,380.56 | $2,380.56 | $2,380.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.39 / $2,084.69 / $8,816.00
| Facility | | $1,040.39 | $2,084.69 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,166.96 / $2,454.03 / $3,123.31
| Facility | | $1,166.96 | $2,454.03 | $3,123.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |