- 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
- $1,311.17 / $1,724.55 / $3,335.83
| Facility | | $1,311.17 | $1,724.55 | $3,335.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $349.73 / $521.16 / $8,816.00
| Facility | | $349.73 | $521.16 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.02 / $817.67 / $3,018.60
| Facility | | $548.02 | $817.67 | $3,018.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |