- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $980.42 / $6,877.55 / $19,760.50
| Facility | | $980.42 | $6,877.55 | $19,760.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,322.00 / $12,191.00 / $30,900.00
| Facility | | $4,322.00 | $12,191.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $959.97 / $1,247.96 / $1,943.94
| Facility | | $959.97 | $1,247.96 | $1,943.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,419.07 / $6,419.07 / $7,609.17
| Facility | | $6,419.07 | $6,419.07 | $7,609.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |