- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,969.00 / $6,611.00 / $16,037.60
| Facility | | $1,969.00 | $6,611.00 | $16,037.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,852.78 / $12,767.46 / $16,845.18
| Facility | | $11,852.78 | $12,767.46 | $16,845.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,558.53 / $9,525.12
| Facility | | $1,474.01 | $6,558.53 | $9,525.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,165.00 / $12,323.40 / $19,089.48
| Facility | | $4,165.00 | $12,323.40 | $19,089.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,578.00 / $8,798.91 / $34,094.93
| Facility | | $3,578.00 | $8,798.91 | $34,094.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,578.00 / $8,645.00 / $17,380.28
| Facility | | $3,578.00 | $8,645.00 | $17,380.28 |