- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.00 / $8,410.44 / $17,025.30
| Facility | | $1,584.00 | $8,410.44 | $17,025.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,358.24 / $6,358.24 / $12,841.54
| Facility | | $6,358.24 | $6,358.24 | $12,841.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,081.00 / $7,298.22 / $10,477.00
| Facility | | $4,081.00 | $7,298.22 | $10,477.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,332.74 / $8,484.01 / $14,865.11
| Facility | | $6,332.74 | $8,484.01 | $14,865.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,719.00 / $6,691.00 / $12,483.22
| Facility | | $2,719.00 | $6,691.00 | $12,483.22 |