- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.58 / $5,826.24 / $11,556.61
| Facility | | $392.58 | $5,826.24 | $11,556.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,309.00 / $6,474.00 / $13,810.27
| Facility | | $3,309.00 | $6,474.00 | $13,810.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.49 / $403.36 / $465.42
| Facility | | $316.49 | $403.36 | $465.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,258.41 / $2,258.41 / $2,258.41
| Facility | | $2,258.41 | $2,258.41 | $2,258.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |