- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $8,477.27 / $19,276.96
| Facility | | $4,382.00 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,193.47 / $8,393.75 / $15,757.21
| Facility | | $6,193.47 | $8,393.75 | $15,757.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $992.70 / $1,780.53 / $8,757.16
| Facility | | $992.70 | $1,780.53 | $8,757.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,781.00 / $2,444.92 / $5,383.60
| Facility | | $1,781.00 | $2,444.92 | $5,383.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |