- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.05 / $8,325.09 / $19,789.00
| Facility | | $3,090.05 | $8,325.09 | $19,789.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $4,988.55 / $12,551.88
| Facility | | $1,474.01 | $4,988.55 | $12,551.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,026.29 / $9,055.36 / $13,910.11
| Facility | | $6,026.29 | $9,055.36 | $13,910.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,267.64 / $8,907.23 / $48,537.00
| Facility | | $5,267.64 | $8,907.23 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,267.64 / $8,907.23 / $15,792.54
| Facility | | $5,267.64 | $8,907.23 | $15,792.54 |