- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,779.00 / $16,018.20 / $22,159.30
| Facility | | $4,779.00 | $16,018.20 | $22,159.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $12,938.42
| Facility | | $1,146.00 | $3,000.00 | $12,938.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,029.02 / $8,330.27 / $15,451.46
| Facility | | $6,029.02 | $8,330.27 | $15,451.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,029.02 / $8,330.27 / $15,451.46
| Facility | | $6,029.02 | $8,330.27 | $15,451.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,492.26 / $10,661.95 / $16,531.52
| Facility | | $4,492.26 | $10,661.95 | $16,531.52 |