- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,478.00 / $15,009.30 / $20,763.59
| Facility | | $4,478.00 | $15,009.30 | $20,763.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,147.09
| Facility | | $1,146.00 | $3,000.00 | $6,147.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,649.29 / $7,805.60 / $14,478.27
| Facility | | $5,649.29 | $7,805.60 | $14,478.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,649.29 / $7,805.60 / $14,478.27
| Facility | | $5,649.29 | $7,805.60 | $14,478.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,209.32 / $9,990.42 / $15,490.30
| Facility | | $4,209.32 | $9,990.42 | $15,490.30 |