- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,000.00 / $8,128.31
| Facility | | $588.84 | $1,000.00 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $28,183.83 / $41,686.94
| Facility | | $5,623.41 | $28,183.83 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $489.78 / $549.54
| Facility | | $446.68 | $489.78 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,456.54 / $7,762.47
| Facility | | $6,456.54 | $6,456.54 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,220.18 / $17,378.01
| Facility | | $5,011.87 | $11,220.18 | $17,378.01 |