- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $8,042.03 / $19,276.96
| Facility | | $4,382.00 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,503.12 / $7,458.15 / $14,000.85
| Facility | | $5,503.12 | $7,458.15 | $14,000.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.35 / $378.25 / $7,772.00
| Facility | | $205.35 | $378.25 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $386.00 / $530.32 / $3,054.91
| Facility | | $386.00 | $530.32 | $3,054.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |