- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $7,285.91 / $15,364.10
| Facility | | $2,318.00 | $7,285.91 | $15,364.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,194.61 / $9,821.77 / $15,379.70
| Facility | | $6,194.61 | $9,821.77 | $15,379.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,602.64 / $10,464.18 / $18,617.43
| Facility | | $6,602.64 | $10,464.18 | $18,617.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,730.00 / $8,044.22 / $22,015.16
| Facility | | $1,730.00 | $8,044.22 | $22,015.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $6,256.00 / $15,936.37
| Facility | | $1,500.00 | $6,256.00 | $15,936.37 |