- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,073.04 / $4,677.34 / $16,467.00
| Facility | | $2,073.04 | $4,677.34 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,511.30 / $11,396.22 / $19,507.71
| Facility | | $5,511.30 | $11,396.22 | $19,507.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,030.88 / $2,030.88 / $2,345.00
| Facility | | $2,030.88 | $2,030.88 | $2,345.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,914.80 / $2,363.00 / $3,957.76
| Facility | | $1,914.80 | $2,363.00 | $3,957.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $17,146.00 / $24,161.00
| Facility | | $3,028.00 | $17,146.00 | $24,161.00 |