- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,158.00 / $8,459.14 / $9,343.04
| Facility | | $4,158.00 | $8,459.14 | $9,343.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,622.00 / $10,960.91 / $18,586.56
| Facility | | $10,622.00 | $10,960.91 | $18,586.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,702.00 / $6,578.00
| Facility | | $1,252.00 | $3,702.00 | $6,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,313.59 / $9,879.16 / $16,955.73
| Facility | | $6,313.59 | $9,879.16 | $16,955.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $14,643.25
| Facility | | $2,332.00 | $5,310.00 | $14,643.25 |