- 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
- $6,193.47 / $8,978.79 / $15,757.21
| Facility | | $6,193.47 | $8,978.79 | $15,757.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $581.77 / $989.01 / $1,698.18
| Facility | | $581.77 | $989.01 | $1,698.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,424.80 / $5,251.23
| Facility | | $1,089.00 | $1,424.80 | $5,251.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,210.00 / $7,221.00 / $8,632.00
| Facility | | $6,210.00 | $7,221.00 | $8,632.00 |