- 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
- $8,430.26 / $12,221.51 / $21,447.95
| Facility | | $8,430.26 | $12,221.51 | $21,447.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.73 / $675.03 / $1,238.13
| Facility | | $385.73 | $675.03 | $1,238.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.00 / $994.62 / $11,757.16
| Facility | | $776.00 | $994.62 | $11,757.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |