- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $8,499.26 / $17,922.80
| Facility | | $2,318.00 | $8,499.26 | $17,922.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,981.48 / $14,588.04 / $25,662.67
| Facility | | $7,981.48 | $14,588.04 | $25,662.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,702.20 / $12,206.82 / $21,717.87
| Facility | | $7,702.20 | $12,206.82 | $21,717.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,730.00 / $8,744.70 / $25,681.42
| Facility | | $1,730.00 | $8,744.70 | $25,681.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $6,359.54 / $18,590.31
| Facility | | $1,500.00 | $6,359.54 | $18,590.31 |