- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,272.93 / $2,138.00 / $8,241.00
| Facility | | $1,272.93 | $2,138.00 | $8,241.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,727.30 / $6,727.30 / $8,072.76
| Facility | | $6,727.30 | $6,727.30 | $8,072.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,326.19 / $1,437.91 / $4,079.92
| Facility | | $1,326.19 | $1,437.91 | $4,079.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,967.35 / $4,967.35 / $4,967.35
| Facility | | $4,967.35 | $4,967.35 | $4,967.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,104.00 / $4,334.00 / $8,676.00
| Facility | | $2,104.00 | $4,334.00 | $8,676.00 |