- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,839.52 / $2,180.17 / $8,229.00
| Facility | | $1,839.52 | $2,180.17 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,720.89 / $10,099.00 / $25,551.65
| Facility | | $7,720.89 | $10,099.00 | $25,551.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,021.60 / $2,774.76 / $3,200.87
| Facility | | $2,021.60 | $2,774.76 | $3,200.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.09 / $2,450.09 / $2,450.09
| Facility | | $2,450.09 | $2,450.09 | $2,450.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.00 / $2,513.00 / $27,879.00
| Facility | | $405.00 | $2,513.00 | $27,879.00 |