- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $8,696.71 / $19,789.00
| Facility | | $3,182.00 | $8,696.71 | $19,789.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,439.37 / $6,587.86 / $8,138.40
| Facility | | $6,439.37 | $6,587.86 | $8,138.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,586.58 / $12,185.35
| Facility | | $1,474.01 | $6,586.58 | $12,185.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,295.31 / $9,459.59 / $13,910.11
| Facility | | $6,295.31 | $9,459.59 | $13,910.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,502.79 / $9,304.85 / $22,793.00
| Facility | | $5,502.79 | $9,304.85 | $22,793.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,502.79 / $7,791.63 / $16,497.53
| Facility | | $5,502.79 | $7,791.63 | $16,497.53 |