- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,322.00 / $14,486.40 / $20,040.30
| Facility | | $4,322.00 | $14,486.40 | $20,040.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $8,505.58
| Facility | | $1,146.00 | $3,000.00 | $8,505.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,452.49 / $7,533.68 / $13,973.89
| Facility | | $5,452.49 | $7,533.68 | $13,973.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,452.49 / $7,779.60 / $13,973.89
| Facility | | $5,452.49 | $7,779.60 | $13,973.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.68 / $9,642.37 / $14,950.66
| Facility | | $4,062.68 | $9,642.37 | $14,950.66 |