- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $7,484.00 / $17,465.30
| Facility | | $2,318.00 | $7,484.00 | $17,465.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,379.57 / $14,030.48
| Facility | | $1,474.01 | $7,379.57 | $14,030.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,165.00 / $13,420.50 / $20,788.93
| Facility | | $4,165.00 | $13,420.50 | $20,788.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,578.00 / $9,495.87 / $39,702.26
| Facility | | $3,578.00 | $9,495.87 | $39,702.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,578.00 / $8,645.00 / $18,927.57
| Facility | | $3,578.00 | $8,645.00 | $18,927.57 |