- 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
- $13,972.71 / $18,377.93 / $35,548.86
| Facility | | $13,972.71 | $18,377.93 | $35,548.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.45 / $818.65 / $8,816.00
| Facility | | $546.45 | $818.65 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $853.52 / $1,291.06 / $4,094.06
| Facility | | $853.52 | $1,291.06 | $4,094.06 |
- 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 |