- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,860.00 / $10,338.04 / $19,997.13
| Facility | | $7,860.00 | $10,338.04 | $19,997.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,674.81 / $6,674.81 / $6,674.81
| Facility | | $6,674.81 | $6,674.81 | $6,674.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.83 / $1,607.95 / $9,496.00
| Facility | | $918.83 | $1,607.95 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,210.46 / $2,352.29 / $8,651.07
| Facility | | $1,210.46 | $2,352.29 | $8,651.07 |
- 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 |