- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.57 / $6,607.00 / $10,492.00
| Facility | | $2,520.57 | $6,607.00 | $10,492.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,873.00 / $11,830.00 / $25,477.00
| Facility | | $8,873.00 | $11,830.00 | $25,477.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.00 / $4,326.79 / $4,326.79
| Facility | | $843.00 | $4,326.79 | $4,326.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,302.00 / $4,390.00 / $5,880.83
| Facility | | $4,302.00 | $4,390.00 | $5,880.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,325.00 / $7,843.00 / $11,371.00
| Facility | | $5,325.00 | $7,843.00 | $11,371.00 |