- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,548.00 / $10,434.20 / $22,776.00
| Facility | | $6,548.00 | $10,434.20 | $22,776.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,268.85 / $10,148.12 / $18,314.23
| Facility | | $4,268.85 | $10,148.12 | $18,314.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $890.00 / $5,740.31
| Facility | | $580.00 | $890.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.14 / $1,151.28 / $1,818.73
| Facility | | $924.14 | $1,151.28 | $1,818.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |