- 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
- $3,896.29 / $5,280.48 / $9,912.79
| Facility | | $3,896.29 | $5,280.48 | $9,912.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.49 / $706.33 / $7,772.00
| Facility | | $356.49 | $706.33 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $677.10 / $961.03 / $3,145.09
| Facility | | $677.10 | $961.03 | $3,145.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $5,105.63 / $7,772.00
| Facility | | $4,217.00 | $5,105.63 | $7,772.00 |