- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,101.98 / $4,706.41 / $16,467.00
| Facility | | $2,101.98 | $4,706.41 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,807.00 / $2,313.35 / $2,916.00
| Facility | | $1,807.00 | $2,313.35 | $2,916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,060.39 / $10,619.00 / $14,963.00
| Facility | | $2,060.39 | $10,619.00 | $14,963.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,917.29 / $2,307.48 / $4,011.90
| Facility | | $1,917.29 | $2,307.48 | $4,011.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.00 / $6,107.00 / $8,818.00
| Facility | | $729.00 | $6,107.00 | $8,818.00 |