- 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
- $7,324.16 / $9,926.11 / $18,633.84
| Facility | | $7,324.16 | $9,926.11 | $18,633.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $876.72 / $1,448.41 / $7,189.00
| Facility | | $876.72 | $1,448.41 | $7,189.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.40 / $1,776.52 / $2,485.26
| Facility | | $1,387.40 | $1,776.52 | $2,485.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.00 / $5,483.00 / $7,934.00
| Facility | | $3,711.00 | $5,483.00 | $7,934.00 |