- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,975.77 / $24,068.03
| Facility | | $5,005.00 | $10,975.77 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,949.08 / $7,762.05 / $15,135.42
| Facility | | $5,949.08 | $7,762.05 | $15,135.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,823.00 / $2,823.00 / $2,823.00
| Facility | | $2,823.00 | $2,823.00 | $2,823.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $790.13 / $1,779.92 / $19,126.55
| Facility | | $790.13 | $1,779.92 | $19,126.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,285.00 / $2,196.28 / $3,939.23
| Facility | | $1,285.00 | $2,196.28 | $3,939.23 |
- 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 |