- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,880.79 / $8,868.41 / $18,023.00
| Facility | | $6,880.79 | $8,868.41 | $18,023.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,616.01 / $7,477.06 / $10,157.41
| Facility | | $1,616.01 | $7,477.06 | $10,157.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.66 / $8,495.94 / $9,713.06
| Facility | | $6,777.66 | $8,495.94 | $9,713.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,434.59 / $12,434.59 / $12,434.59
| Facility | | $12,434.59 | $12,434.59 | $12,434.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,858.41 / $8,001.24 / $11,697.08
| Facility | | $1,858.41 | $8,001.24 | $11,697.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,796.82 / $12,007.30
| Facility | | $1,286.00 | $7,796.82 | $12,007.30 |