- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,672.00 / $9,544.15 / $20,928.72
| Facility | | $3,672.00 | $9,544.15 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,792.03 / $6,792.03 / $6,792.03
| Facility | | $6,792.03 | $6,792.03 | $6,792.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.45 / $994.56 / $8,892.70
| Facility | | $523.45 | $994.56 | $8,892.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $838.00 / $1,409.65 / $8,603.24
| Facility | | $838.00 | $1,409.65 | $8,603.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |