- 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
- $4,609.82 / $6,247.48 / $11,728.12
| Facility | | $4,609.82 | $6,247.48 | $11,728.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,305.32 / $2,249.64 / $7,699.45
| Facility | | $1,305.32 | $2,249.64 | $7,699.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,830.79 / $2,587.75 / $3,915.15
| Facility | | $1,830.79 | $2,587.75 | $3,915.15 |
- 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 |