- 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
- $6,619.76 / $8,971.48 / $16,841.75
| Facility | | $6,619.76 | $8,971.48 | $16,841.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $519.94 / $849.42 / $9,480.17
| Facility | | $519.94 | $849.42 | $9,480.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $877.64 / $1,166.65 / $5,870.28
| Facility | | $877.64 | $1,166.65 | $5,870.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |