- 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
- $4,048.69 / $5,487.01 / $10,300.52
| Facility | | $4,048.69 | $5,487.01 | $10,300.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.94 / $830.59 / $7,772.00
| Facility | | $471.94 | $830.59 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $887.55 / $1,105.91 / $3,145.09
| Facility | | $887.55 | $1,105.91 | $3,145.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |