- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $7,419.46 / $11,946.30
| Facility | | $1,638.00 | $7,419.46 | $11,946.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,246.30 / $6,536.76 / $18,597.64
| Facility | | $5,246.30 | $6,536.76 | $18,597.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $2,555.21 / $6,242.69
| Facility | | $1,474.01 | $2,555.21 | $6,242.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,045.00 / $7,045.00 / $7,094.35
| Facility | | $7,045.00 | $7,045.00 | $7,094.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,694.60 / $6,506.44 / $13,664.34
| Facility | | $4,694.60 | $6,506.44 | $13,664.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,407.75 / $6,506.44 / $13,840.77
| Facility | | $4,407.75 | $6,506.44 | $13,840.77 |