- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $8,477.27 / $19,276.96
| Facility | | $4,382.00 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,086.90 / $12,315.08 / $23,118.55
| Facility | | $9,086.90 | $12,315.08 | $23,118.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $790.43 / $1,423.52 / $8,816.00
| Facility | | $790.43 | $1,423.52 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,357.00 / $1,845.96 / $5,383.60
| Facility | | $1,357.00 | $1,845.96 | $5,383.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |