- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,435.00 / $9,558.00 / $17,247.00
| Facility | | $3,435.00 | $9,558.00 | $17,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,740.35 / $9,528.23 / $16,900.34
| Facility | | $3,740.35 | $9,528.23 | $16,900.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.00 / $3,711.96 / $4,769.93
| Facility | | $1,130.00 | $3,711.96 | $4,769.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.68 / $1,896.86 / $3,362.94
| Facility | | $1,481.68 | $1,896.86 | $3,362.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,354.02 / $15,451.00 / $23,485.00
| Facility | | $4,354.02 | $15,451.00 | $23,485.00 |