- 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
- $4,896.35 / $6,635.81 / $12,457.11
| Facility | | $4,896.35 | $6,635.81 | $12,457.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.26 / $509.98 / $8,816.00
| Facility | | $295.26 | $509.98 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.61 / $668.12 / $943.77
| Facility | | $540.61 | $668.12 | $943.77 |
- 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 |