- 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
- $7,653.53 / $11,095.47 / $19,471.83
| Facility | | $7,653.53 | $11,095.47 | $19,471.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.34 / $712.85 / $1,387.87
| Facility | | $407.34 | $712.85 | $1,387.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.92 / $1,151.90 / $8,568.00
| Facility | | $810.92 | $1,151.90 | $8,568.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |