- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,742.00 / $7,202.97 / $19,789.00
| Facility | | $2,742.00 | $7,202.97 | $19,789.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,377.11 / $3,655.36 / $9,212.36
| Facility | | $1,377.11 | $3,655.36 | $9,212.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,214.02 / $7,133.50 / $13,336.31
| Facility | | $5,214.02 | $7,133.50 | $13,336.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,557.63 / $7,874.94 / $48,537.00
| Facility | | $4,557.63 | $7,874.94 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,557.63 / $7,706.65 / $13,663.90
| Facility | | $4,557.63 | $7,706.65 | $13,663.90 |