- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,742.00 / $5,473.49 / $19,789.00
| Facility | | $2,742.00 | $5,473.49 | $19,789.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $4,809.62 / $7,447.64
| Facility | | $1,474.01 | $4,809.62 | $7,447.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,962.10 / $5,953.62 / $10,134.17
| Facility | | $3,962.10 | $5,953.62 | $10,134.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,463.31 / $4,799.93 / $10,080.46
| Facility | | $3,463.31 | $4,799.93 | $10,080.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,251.69 / $4,799.93 / $10,210.62
| Facility | | $3,251.69 | $4,799.93 | $10,210.62 |