- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,437.58 / $3,391.08 / $16,467.00
| Facility | | $1,437.58 | $3,391.08 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,114.82 / $27,416.96 / $43,667.88
| Facility | | $12,114.82 | $27,416.96 | $43,667.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.00 / $890.00 / $1,431.62
| Facility | | $890.00 | $890.00 | $1,431.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,396.61 / $1,742.14 / $2,772.71
| Facility | | $1,396.61 | $1,742.14 | $2,772.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $19,915.00 / $30,476.00
| Facility | | $3,340.00 | $19,915.00 | $30,476.00 |