- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $8,477.27 / $19,276.96
| Facility | | $4,382.00 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,281.85 / $5,631.80 / $10,893.72
| Facility | | $4,281.85 | $5,631.80 | $10,893.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $785.96 / $1,753.38 / $7,129.85
| Facility | | $785.96 | $1,753.38 | $7,129.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,264.33 / $1,926.47 / $2,521.31
| Facility | | $1,264.33 | $1,926.47 | $2,521.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |