- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,119.43 / $13,792.60 / $22,207.80
| Facility | | $5,119.43 | $13,792.60 | $22,207.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $10,871.53 / $20,113.41
| Facility | | $1,474.01 | $10,871.53 | $20,113.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,984.04 / $14,421.01 / $20,429.09
| Facility | | $9,984.04 | $14,421.01 | $20,429.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $9,416.37 / $24,980.74
| Facility | | $800.00 | $9,416.37 | $24,980.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $9,689.31 / $19,808.68
| Facility | | $800.00 | $9,689.31 | $19,808.68 |