- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,847.00 / $12,386.60 / $24,472.10
| Facility | | $1,847.00 | $12,386.60 | $24,472.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,209.34 / $11,396.09 / $20,074.06
| Facility | | $7,209.34 | $11,396.09 | $20,074.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,339.26 / $3,142.79 / $13,976.85
| Facility | | $1,339.26 | $3,142.79 | $13,976.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,470.00 / $17,470.00 / $24,884.37
| Facility | | $10,470.00 | $17,470.00 | $24,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $14,314.60 / $22,016.15
| Facility | | $3,496.00 | $14,314.60 | $22,016.15 |