- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,404.84 / $15,307.00 / $38,871.00
| Facility | | $2,404.84 | $15,307.00 | $38,871.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,437.00 / $16,995.89 / $28,307.41
| Facility | | $6,437.00 | $16,995.89 | $28,307.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,229.55 / $6,229.55 / $8,005.08
| Facility | | $6,229.55 | $6,229.55 | $8,005.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $982.51 / $1,338.41 / $1,946.85
| Facility | | $982.51 | $1,338.41 | $1,946.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,902.53 / $17,146.00 / $24,161.00
| Facility | | $7,902.53 | $17,146.00 | $24,161.00 |