- 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
- $5,198.33 / $7,045.08 / $13,225.41
| Facility | | $5,198.33 | $7,045.08 | $13,225.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.05 / $608.61 / $8,632.00
| Facility | | $344.05 | $608.61 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $643.75 / $857.71 / $4,164.35
| Facility | | $643.75 | $857.71 | $4,164.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,848.70 / $7,221.00 / $8,816.00
| Facility | | $3,848.70 | $7,221.00 | $8,816.00 |