- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $6,953.00 / $14,972.00
| Facility | | $2,318.00 | $6,953.00 | $14,972.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,870.72 / $8,732.44
| Facility | | $1,474.01 | $5,870.72 | $8,732.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,165.00 / $11,504.60 / $17,821.13
| Facility | | $4,165.00 | $11,504.60 | $17,821.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,578.00 / $8,692.00 / $30,111.02
| Facility | | $3,578.00 | $8,692.00 | $30,111.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,578.00 / $8,279.00 / $16,225.49
| Facility | | $3,578.00 | $8,279.00 | $16,225.49 |