- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,838.06 / $3,007.90 / $12,247.00
| Facility | | $1,838.06 | $3,007.90 | $12,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.48 / $3,394.57 / $5,654.79
| Facility | | $1,182.48 | $3,394.57 | $5,654.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,367.00 / $2,077.01 / $3,329.18
| Facility | | $1,367.00 | $2,077.01 | $3,329.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.00 / $2,050.00 / $15,712.00
| Facility | | $1,461.00 | $2,050.00 | $15,712.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,644.48 / $16,894.64 / $26,542.00
| Facility | | $13,644.48 | $16,894.64 | $26,542.00 |