- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,090.00 / $8,031.00 / $24,819.26
| Facility | | $4,090.00 | $8,031.00 | $24,819.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,062.44 / $12,098.00 / $17,206.00
| Facility | | $1,062.44 | $12,098.00 | $17,206.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $998.00 / $10,904.32 / $12,554.23
| Facility | | $998.00 | $10,904.32 | $12,554.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,608.60 / $3,091.56 / $3,254.67
| Facility | | $1,608.60 | $3,091.56 | $3,254.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,354.00 / $9,642.00 / $17,777.00
| Facility | | $1,354.00 | $9,642.00 | $17,777.00 |